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General NPI Number Information
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NPI Number | 1730640509
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Entity Type | Individual
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Provider Name | DAVID THORNE HOLLAND DDS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 12983 SOUTHERN BLVD STE 203
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9207
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Country | US
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Telephone | 609-240-5670
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Fax |
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Provider Business Mailing Address
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Address Line | 12983 SOUTHERN BLVD STE 203
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9207
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Country | US
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Telephone | 609-240-5670
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN27830
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License Number State | FL
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