MEDICARE: DR. CYNTHIA M AITA-HOLMES DMD

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	1223P0700X	Prosthodontics	052713	NY

General Provider Information

NPI Number	:	1841273737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA M AITA-HOLMES DMD

Provider Business Mailing Address
First Line	:	1060 GAFFNEY #7500
Second Line	:
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703-7500
Country	:	US
Telephone Number	:	907-353-4114
Fax Number	:	907-353-4852

Provider Business Practice Location Address
First Line	:	1060 GAFFNEY #7500
Second Line	:
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703-7500
Country	:	US
Telephone Number	:	907-353-4114
Fax Number	:	907-353-4852

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	09/11/2009

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