MEDICARE: DR. JOSEPH HENDERSON HOLCOMB DDS

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	17145	TX

General Provider Information

NPI Number	:	1942318035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH HENDERSON HOLCOMB DDS

Provider Business Mailing Address
First Line	:	1050 E LOOP 304
Second Line	:	SUITE #120
City	:	CROCKETT
State	:	TX
Zip	:	75835-1814
Country	:	US
Telephone Number	:	936-544-3554
Fax Number	:	936-546-0355

Provider Business Practice Location Address
First Line	:	1050 E LOOP 304
Second Line	:	SUITE #120
City	:	CROCKETT
State	:	TX
Zip	:	75835-1814
Country	:	US
Telephone Number	:	936-544-3554
Fax Number	:	936-546-0355

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

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	07/08/2007

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