Healthcare Provider Details

I. General information

NPI: 1972880110
Provider Name (Legal Business Name): HOLMAN DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8745 N LAMAR BLVD
AUSTIN TX
78753-5423
US

IV. Provider business mailing address

8745 N LAMAR BLVD
AUSTIN TX
78753-5423
US

V. Phone/Fax

Practice location:
  • Phone: 512-832-6395
  • Fax: 512-276-6638
Mailing address:
  • Phone: 512-832-6395
  • Fax: 512-276-6638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. DUNG T DANG
Title or Position: MANAGER
Credential: D.D.S
Phone: 512-973-8997