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General NPI Number Information
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NPI Number | 1306171392
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Entity Type | Organization
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Legal Business Name | SHARON L HOLLEY, DMD PA
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 10115 HICKORYWOOD HILL AVE
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3422
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Country | US
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Telephone | 704-948-8494
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Fax | 704-948-8482
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Provider Business Mailing Address
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Address Line | 10115 HICKORYWOOD HILL AVE
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3422
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Country | US
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Telephone | 704-948-8494
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Fax | 704-948-8482
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. SHARON LAVERNE HOLLEY
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Credential | DMD
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Telephone | 704-948-8494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 7045
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License Number State | NC
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