# JH DENTAL

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

## Provider details

- **NPI number:** 1780179218
- **Authorized official:** JACOB HOLLY DMD (DENTIST)
- **Authorized official phone:** (623) 692-4774

## Contact information

- **Practice address:** 42104 N VENTURE DR, ANTHEM, AZ 85086-3823
- **Practice address phone:** (623) 551-6300
- **Mailing address:** 9533 W BLUE SKY DR, PEORIA, AZ 85383-8741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/27/2018
- **Last updated:** 06/27/2018