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Individual
DR. HOLLY ROSE BENNETT
Active
Individual
DR. HOLLY ROSE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4302
AR
1223G0001X
General Practice Dentistry
4302
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Enumeration date
07/05/2018
Last updated
09/23/2019
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