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General NPI Number Information
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NPI Number | 1194663112
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Entity Type | Individual
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Provider Name | CASEY HOLMES
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Gender |
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 6238 ARDENNES STREET BUILDING #C-6238
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City | FORT BRAGG
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State | NC
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Zip | 28310-0001
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Country | US
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Telephone | 910-432-8170
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 ANNAPOLIS RD STE A7
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City | LANHAM
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State | MD
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Zip | 20706-2061
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Country | US
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Telephone | 301-577-7107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 13809
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License Number State | NC
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