Individual
DR. CHANELLE MARIE HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2109 VICTORY BLVD, STATEN ISLAND, NY 10314-6601
(718) 494-1300
Mailing address
420 E 54TH ST APT 307, NEW YORK, NY 10022-5297
(347) 969-1250
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
14166
CT
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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