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General NPI Number Information
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NPI Number | 1891794806
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Entity Type | Individual
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Provider Name | BRIAN GLEN HOLMES DMD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1254 BAY ST
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City | FLORENCE
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State | OR
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Zip | 97439-9648
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Country | US
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Telephone | 541-997-3535
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Fax | 541-997-3186
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Provider Business Mailing Address
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Address Line | 1254 BAY ST PO BOX 2956
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City | FLORENCE
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State | OR
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Zip | 97439-9648
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Country | US
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Telephone | 541-997-3535
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Fax | 541-997-3186
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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 | DE61472512
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE61472512
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D7754
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License Number State | OR
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