Healthcare Provider Details

I. General information

NPI: 1649471327
Provider Name (Legal Business Name): HOLLAND DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 W STEAMBOAT DR SUITE 101
DAKOTA DUNES SD
57049-5389
US

IV. Provider business mailing address

383 W STEAMBOAT DR SUITE 101
DAKOTA DUNES SD
57049-5389
US

V. Phone/Fax

Practice location:
  • Phone: 605-232-5898
  • Fax:
Mailing address:
  • Phone: 605-232-5898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS W. HOLLAND
Title or Position: DENTIST
Credential:
Phone: 605-232-5898