Organization
HOLLEY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES W HOLLEY IV D.D.S. (OWNER/PRESIDENT)
(757) 595-3503
Entity
Organization
Contact information
Practice address
446 EFFINGHAM ST, PORTSMOUTH, VA 23704-3416
(757) 393-2401
(757) 595-3816
Mailing address
446 EFFINGHAM ST, PORTSMOUTH, VA 23704-3416
(757) 393-2401
(757) 595-3816
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0470107431
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7831587
—
VA
Enumeration date
09/20/2007
Last updated
09/20/2007
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