| Barry L Holden Dmd Pc | |
|
110 Regent Ct Ste 100 State College PA 16801-7966 | |
| (814) 231-0110 | |
| (814) 231-0118 |
| Full Name | Barry L Holden Dmd Pc |
|---|---|
| Speciality | Dentist |
| Location | 110 Regent Ct, State College, Pennsylvania |
| Authorized Official Name and Position | Barry Lee Holden (PRESIDENT) |
| Authorized Official Contact | 8142310110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barry L Holden Dmd Pc 110 Regent Ct Ste 100 State College PA 16801-7966 Ph: (814) 231-0110 | Barry L Holden Dmd Pc 110 Regent Ct Ste 100 State College PA 16801-7966 Ph: (814) 231-0110 |
| NPI Number | 1639199433 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 01/16/2008 |
| Medicare PECOS PAC ID | 1456419019 |
|---|---|
| Medicare Enrollment ID | O20081027000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639199433 | NPI | - | NPPES |
| 411542 | Other | PA | BCBS |
| 411542 | Other | PA | UCCI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DS024069L (Pennsylvania) | Primary |
| 261QD0000X | Clinic/center - Dental | DS024069L (Pennsylvania) | Secondary |
| Provider Name | Barry L Holden |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376795393 PECOS PAC ID: 9335207117 Enrollment ID: I20081023000077 |
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