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Organization

KENNETH EUGENE HOLLAND, JR., DDS, MS, PLLC

Active
Other names
Kenneth E Holland, Jr, DDS, MS
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH EUGENE HOLLAND JR. DDS, MS (PRESIDENT)
(928) 710-4974
Entity
Organization

Contact information

Practice address
13821 N 35TH DR, SUITE 1, PHOENIX, AZ 85053-5541
(928) 710-4974
Mailing address
1560 W SAHUARO DR, APT 2, PHOENIX, AZ 85029-5070
(928) 710-4974

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4291
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
422056
DEPT OF ECONOM SEC - CMDP
AZ
Enumeration date
05/11/2007
Last updated
01/17/2014
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