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Organization
MANDY L HOLLEY DDS PA
Active
Organization
MANDY L HOLLEY DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY L HOLLEY DDS (OWNER)
(512) 598-1517
Entity
Organization
Contact information
Practice address
3622 WILLIAMS DR STE 2, GEORGETOWN, TX 78628-2508
(512) 598-1517
Mailing address
3622 WILLIAMS DR STE 2, GEORGETOWN, TX 78628-2508
(512) 598-1517
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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