Organization
CW HOLLAND DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WAYNE HOLLAND DDS (PRESIDENT)
(252) 237-3117
Entity
Organization
Contact information
Practice address
1310 NASH STREET NORTH, WILSON, NC 27893
(252) 237-3117
Mailing address
1310 NASH STREET NORTH, WILSON, NC 27893
(252) 237-3117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3934
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3934
DELTA DENTAL
NC
05
—
8994025
—
NC
01
—
94025
BLUE CROSS BLUE SHIELD
NC
Enumeration date
10/21/2006
Last updated
08/22/2020
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