Provider Demographics
NPI:1659463685
Name:HOLDER, JEAN FRANCES (DDS)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:FRANCES
Last Name:HOLDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:IN
Mailing Address - Zip Code:46105-9613
Mailing Address - Country:US
Mailing Address - Phone:765-522-6834
Mailing Address - Fax:765-522-6783
Practice Address - Street 1:7127 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:IN
Practice Address - Zip Code:46105-9613
Practice Address - Country:US
Practice Address - Phone:765-522-6834
Practice Address - Fax:765-522-6783
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009285A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice