MEDICARE: JAMES HOLT, DDS, PA

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
1	1223G0001X	General Practice Dentistry	18125	TX

General Provider Information

NPI Number	:	1447470026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES HOLT, DDS, PA

Provider Business Mailing Address
First Line	:	600 E. SOUTHLAKE BLVD.
Second Line	:	#100
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6254
Country	:	US
Telephone Number	:	817-488-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 E SOUTHLAKE BLVD
Second Line	:	#100
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6254
Country	:	US
Telephone Number	:	817-488-2273
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAMES HANSFORD HOLT
Credential	:	DDS
Telephone Number	:	817-488-2273

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	08/22/2020

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