Individual
RANDOLPH HOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1003 MONROE STREET, ENDICOTT, NY 13760
(607) 757-0455
(607) 757-9375
Mailing address
1003 MONROE ST, ENDICOTT, NY 13760-5221
(607) 757-0455
(607) 757-9375
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0369901
NY
Other
Enumeration date
11/09/2006
Last updated
07/09/2007
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