Provider Demographics
NPI:1982977823
Name:DAVID HOLGUIN
Entity Type:Organization
Organization Name:DAVID HOLGUIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALONSO
Authorized Official - Last Name:HOLGUIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-613-5758
Mailing Address - Street 1:306 E. PAISANO PMB 1357
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901
Mailing Address - Country:US
Mailing Address - Phone:915-613-3758
Mailing Address - Fax:915-613-3758
Practice Address - Street 1:PEDRO S. VARELA 3007
Practice Address - Street 2:
Practice Address - City:CD JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32317
Practice Address - Country:MX
Practice Address - Phone:01152-616-1509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ3023198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty