Healthcare Provider Details

I. General information

NPI: 1275794604
Provider Name (Legal Business Name): GARY M HOLT D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7889 S LINCOLN CT SUITE 102
LITTLETON CO
80122-2651
US

IV. Provider business mailing address

7889 S LINCOLN CT SUITE 102
LITTLETON CO
80122-2651
US

V. Phone/Fax

Practice location:
  • Phone: 303-798-0928
  • Fax: 303-798-2531
Mailing address:
  • Phone: 303-798-0928
  • Fax: 303-798-2531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY M HOLT
Title or Position: OWNER
Credential:
Phone: 303-798-0928