# HOLLEY FAMILY DENTISTRY FREDERICKSBURG

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

## Provider details

- **NPI number:** 1467606608
- **Authorized official:** MRS. NICHOLE P LIVESAY (OFFICE MANAGER)
- **Authorized official phone:** (540) 785-5885

## Contact information

- **Practice address:** 974 BRAGG RD, FREDERICKSBURG, VA 22407-6979
- **Practice address phone:** (540) 785-5885
- **Mailing address:** 974 BRAGG RD, FREDERICKSBURG, VA 22407-6979
- **Mailing address phone:** (540) 785-5885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7431 | VA | Yes |

## Other

- **Enumeration date:** 11/14/2008
- **Last updated:** 11/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6239 | — | VA |