Individual
DR. BRENT L HOLMAN
Active
Individual
DR. BRENT L HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1587
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26296
BLUE CROSS BLUE SHIELD
ND
01
—
330
DELTA DENTAL
MN
05
—
370720200
—
MN
05
—
40633
—
ND
01
—
91799110
BLUE CROSS BLUE SHIELD
MN
Enumeration date
12/17/2006
Last updated
05/01/2014
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