| Kenneth Eugene Holland, Jr., Dds, Ms, Pllc | |
|
13821 N 35th Dr Suite 1 Phoenix AZ 85053-5541 | |
| (928) 710-4974 | |
| Not Available |
| Full Name | Kenneth Eugene Holland, Jr., Dds, Ms, Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 13821 N 35th Dr, Phoenix, Arizona |
| Authorized Official Name and Position | Kenneth Eugene Holland (PRESIDENT) |
| Authorized Official Contact | 9287104974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Eugene Holland, Jr., Dds, Ms, Pllc 1560 W Sahuaro Dr Apt 2 Phoenix AZ 85029-5070 Ph: (928) 710-4974 | Kenneth Eugene Holland, Jr., Dds, Ms, Pllc 13821 N 35th Dr Suite 1 Phoenix AZ 85053-5541 Ph: (928) 710-4974 |
| NPI Number | 1437364809 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 01/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437364809 | NPI | - | NPPES |
| 422056 | Other | AZ | DEPT OF ECONOM SEC - CMDP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 4291 (Arizona) | Primary |
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