Individual
JOHN ANDREW HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
Mailing address
2092 NORTHTREE DR NE, KEIZER, OR 97303-1974
(503) 393-6814
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D7112
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223S0112X
ORAL SURGERY
OR
Enumeration date
08/19/2006
Last updated
07/08/2007
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