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Organization
HOLLY DENTAL PLLC
Active
Organization
HOLLY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINEET SHARMA DDS (OWNER/DENTIST)
(903) 707-8941
Entity
Organization
Contact information
Practice address
1050 E BROADWAY AVE, SUITE 102, GLADEWATER, TX 75647
(903) 707-8941
(903) 765-5309
Mailing address
1050 E BROADWAY AVE, SUITE 102, GLADEWATER, TX 75647
(903) 707-8941
(903) 765-5309
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30165
TEXAS STATE BOARD OF DENTAL EXAMINERS
TX
Enumeration date
04/01/2021
Last updated
04/01/2021
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