Individual
DR. BRANDON JEFFREY HOLYOAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
314 E ALBENI HWY, PRIEST RIVER, ID 83856-9207
(208) 448-2694
Mailing address
314 E ALBENI HWY, PRIEST RIVER, ID 83856-9207
(208) 448-2694
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-4307
ID
1223G0001X
General Practice Dentistry
Primary
D-4307
ID
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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