Individual
DR. RICHARD MARK HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, PA
Contact information
Practice address
136 INDIAN TRAIL RD S, INDIAN TRAIL, NC 28079-9669
(704) 821-7222
(704) 821-4310
Mailing address
136 INDIAN TRAIL RD S, PO BOX 338, INDIAN TRAIL, NC 28079-9669
(704) 821-7222
(704) 821-4310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NC6039
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994009
—
NC
01
—
94009
BC BS PROVIDER ID NUMBER
NC
Enumeration date
10/23/2006
Last updated
07/09/2007
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