Provider Demographics
NPI:1912048786
Name:HOLLAND, THOMAS LEE
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 MADISON BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2085
Mailing Address - Country:US
Mailing Address - Phone:256-895-0905
Mailing Address - Fax:256-895-9454
Practice Address - Street 1:7736 MADISON BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2085
Practice Address - Country:US
Practice Address - Phone:256-895-0905
Practice Address - Fax:256-895-9454
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL39401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice