MEDICARE: DR. ADAM LINWOOD HOLT D.M.D.

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	122300000X	Dentist	0401416292	VA

General Provider Information

NPI Number	:	1326364357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM LINWOOD HOLT D.M.D.

Provider Business Mailing Address
First Line	:	4370 STARKEY RD STE 1B
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0603
Country	:	US
Telephone Number	:	540-989-0112
Fax Number	:

Provider Business Practice Location Address
First Line	:	4370 STARKEY RD STE 1B
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0603
Country	:	US
Telephone Number	:	540-989-0112
Fax Number	:

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

Provider Enumeration Date	:	04/15/2010
Last Update Date	:	05/02/2022

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