Individual
DR. MICHAEL PETER HOLUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
513 N MAIN ST, ANNA, IL 62906-1668
(618) 833-4471
(618) 833-6267
Mailing address
513 N MAIN ST, ANNA, IL 62906-1668
(618) 833-4471
(618) 833-6267
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-022619
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002247
—
IL
Enumeration date
01/31/2007
Last updated
04/20/2017
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