MEDICARE: DR. LUZ HOLLOWAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	36326	CA

General Provider Information

NPI Number	:	1285744136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUZ HOLLOWAY

Provider Business Mailing Address
First Line	:	1241 W CARSON ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90502-2009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1241 W CARSON ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90502-2009
Country	:	US
Telephone Number	:	310-328-1145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. LUZ HOLLOWAY ” Practice Location

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