Organization
HOLDEN DENTAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN GRAHAM (VICE PRESIDENT)
(407) 858-0321
Entity
Organization
Contact information
Practice address
4638 S ORANGE BLOSSOM TRL, ORLANDO, FL 32839-1706
(407) 858-0321
Mailing address
4638 S ORANGE BLOSSOM TRL, ORLANDO, FL 32839-1706
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070850000
—
FL
Enumeration date
04/02/2007
Last updated
05/05/2008
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