Provider Demographics
NPI:1841355286
Name:HOLLAND, WALTER B JR (DDS)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:B
Last Name:HOLLAND
Suffix:JR
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 1:360 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14204-1511
Mailing Address - Country:US
Mailing Address - Phone:716-854-1038
Mailing Address - Fax:716-847-4352
Practice Address - Street 1:360 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-1511
Practice Address - Country:US
Practice Address - Phone:716-854-1038
Practice Address - Fax:716-847-4352
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice