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General NPI Number Information
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NPI Number | 1508509803
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Entity Type | Organization
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Legal Business Name | KEVIN HOLLEY DMD PLLC
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 107 OAKMONT DR
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City | GREENVILLE
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State | NC
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Zip | 27858-5937
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Country | US
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Telephone | 252-321-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 107 OAKMONT DR
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City | GREENVILLE
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State | NC
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Zip | 27858-5937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/DENTIST
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Name | KEVIN HOLLEY
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Credential | DMD
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Telephone | 252-702-9043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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