Individual
KELLY ANNE HOLST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
716 STEVENS AVE, PORTLAND, ME 04103-2656
(207) 221-4294
Mailing address
1264 SYLVAN RD, PERKASIE, PA 18944-3910
(215) 534-8031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN5102
ME
1223G0001X
General Practice Dentistry
DS041822
PA
Other
Enumeration date
07/23/2018
Last updated
02/05/2024
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