Individual
DR. JACK L HOLLY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
417 HUDSON DR, ELIZABETHTON, TN 37643-2881
(423) 543-4141
(423) 543-6606
Mailing address
417 HUDSON DR, ELIZABETHTON, TN 37643-2881
(423) 543-4141
(423) 543-6606
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS2986
TN
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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