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General NPI Number Information
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NPI Number | 1366451932
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Entity Type | Individual
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Provider Name | MARY WENDY HOLDER DMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 980 AIRPORT DR
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City | ALEXANDER CITY
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State | AL
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Zip | 35010-3431
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Country | US
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Telephone | 256-234-6841
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Fax | 256-329-8509
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Provider Business Mailing Address
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Address Line | 980 AIRPORT DR
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City | ALEXANDER CITY
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State | AL
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Zip | 35010-3431
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Country | US
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Telephone | 256-234-6841
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Fax | 256-329-8509
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 4164
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License Number State | AL
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