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General NPI Number Information
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NPI Number | 1548393648
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Entity Type | Organization
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Legal Business Name | JOHN R HOLCOMB DDS PA
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 740 S HOLLY ST
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761-3304
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Country | US
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Telephone | 479-549-4746
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Fax |
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Provider Business Mailing Address
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Address Line | 740 S HOLLY ST
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761-3304
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Country | US
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Telephone | 479-549-4746
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN R HOLCOMB
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Credential | DDS
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Telephone | 479-549-4746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 3236
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License Number State | AR
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