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General NPI Number Information
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NPI Number | 1619083565
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Entity Type | Individual
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Provider Name | ERIC P HOLMGREN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | ORAL AND FACIAL SURGERY ASSOCIATES 77 HOSPITAL DRIVE
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City | NORTH ADAMS
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State | MA
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Zip | 01247
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Country | US
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Telephone | 413-664-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 77 HOSPITAL AVE STE 212
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City | NORTH ADAMS
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State | MA
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Zip | 01247-2538
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Country | US
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Telephone | 413-664-4100
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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 | 04324
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 016.0002228
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 18361
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 227532
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License Number State | MA
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