Healthcare Provider Details

I. General information

NPI: 1376598243
Provider Name (Legal Business Name): ROBERT GARY HOLMES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 N SARATOGA ST
OAK HARBOR WA
98278-4927
US

IV. Provider business mailing address

3475 N SARATOGA ST
OAK HARBOR WA
98278-4927
US

V. Phone/Fax

Practice location:
  • Phone: 360-257-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN011091
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number11091
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN11091
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: