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NPI Code Detail

MEDICARE: DR. COLLIN DOUGLAS HOLMAN DDS

MEDICARE: DR. COLLIN DOUGLAS HOLMAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6733NE

General Provider Information

NPI Number : 1295914133
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COLLIN DOUGLAS HOLMAN DDS
Provider Business Mailing Address
First Line : 4175 S ALAMO AVE
Second Line :
City : DAVIS MONTHAN AFB
State : AZ
Zip : 85707-4402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4175 S ALAMO AVE
Second Line :
City : DAVIS MONTHAN AFB
State : AZ
Zip : 85707-4402
Country : US
Telephone Number : 202-282-7155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2007
Last Update Date : 08/09/2024

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