Organization
KEVIN HOLLY DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HOLLY DDS (PRESIDENT)
(608) 738-6361
Entity
Organization
Contact information
Practice address
520 HIGHWAY 96 W STE 400, SHOREVIEW, MN 55126-3201
(651) 482-7564
Mailing address
520 HIGHWAY 96 W STE 400, SHOREVIEW, MN 55126-3201
(651) 482-7564
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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