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General NPI Number Information
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NPI Number | 1417626060
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Entity Type | Individual
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Provider Name | BRIAN AARON HOLTAN DMD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 13909 W CAMINO DEL SOL STE 102
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-1413
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Country | US
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Telephone | 623-584-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 13909 W CAMINO DEL SOL STE 102
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-1413
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Country | US
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Telephone | 623-584-9844
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D011188
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License Number State | AZ
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