# HOLECEK FAMILY DENTAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194975755
- **Authorized official:** DR. DAVID MARK HOLECEK DDS (OWNER MANAGER)
- **Authorized official phone:** (208) 777-9599

## Contact information

- **Practice address:** 1100 E POLSTON AVE, STE B, POST FALLS, ID 83854
- **Practice address phone:** (208) 777-9599
- **Practice address fax:** (208) 777-1627
- **Mailing address:** 1100 E POLSTON AVE, STE B, POST FALLS, ID 83854
- **Mailing address phone:** (208) 777-9599
- **Mailing address fax:** (208) 777-1627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3552 | ID | Yes |

## Other

- **Enumeration date:** 09/19/2008
- **Last updated:** 11/13/2013