Individual
CODY JOHN HOLMGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6050 STERLING CREEK RD, PORTAGE, IN 46368-7752
(219) 763-8112
Mailing address
6050 STERLING CREEK RD, PORTAGE, IN 46368-7752
(219) 763-8112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014417A
IN
Other
Enumeration date
10/13/2023
Last updated
05/30/2024
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