Provider Demographics
NPI:1457978785
Name:HOLCOMB, CHRISTOPHER AS (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:AS
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 ANDERSON DR APT 206
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-5808
Mailing Address - Country:US
Mailing Address - Phone:812-241-9946
Mailing Address - Fax:
Practice Address - Street 1:4217 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5550
Practice Address - Country:US
Practice Address - Phone:812-332-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013429A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice