Individual
MR. DEMENTRE HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
11409 N 58TH DR, GLENDALE, AZ 85304-3312
(480) 577-7096
(800) 869-4964
Mailing address
11409 N 58TH DR, GLENDALE, AZ 85304-3312
(480) 577-7096
(800) 869-4964
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2447I
AZ
Other
Enumeration date
12/16/2013
Last updated
05/03/2021
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