MEDICARE: STEVEN A HOLLEY 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
1	122300000X	Dentist	27295	CA

General Provider Information

NPI Number	:	1659381689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN A HOLLEY DDS

Provider Business Mailing Address
First Line	:	3324 SW ARNOLD HEIGHTS TER
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-9219
Country	:	US
Telephone Number	:	503-341-2196
Fax Number	:

Provider Business Practice Location Address
First Line	:	3324 SW ARNOLD HEIGHTS TER
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-9219
Country	:	US
Telephone Number	:	503-341-2196
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	11/09/2020

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Directions to “ STEVEN A HOLLEY DDS” Practice Location

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