Jack Robert Holt DDS

NPI 1629293618 - Dentist - 122300000X

NPI Details
NPI 1629293618
Gender Male
Enumeration Date 04/16/2007
Last Updated 05/09/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
1213 COFFEE RD
SUITE M
MODESTO CA, 95355-4229, US
Phone (209) 521-5959
Fax (209) 521-1082
Business Location
1213 COFFEE RD
SUITE M
MODESTO CA, 95355-4229, US
Phone (209) 521-5959
Fax (209) 521-1082
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 16922
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According to our database, Dr. Jack Robert Holt DDS NPI is 1629293618, taxonomy code is 122300000X and license number is 16922, license state is located at California. Jack Robert Holt DDS physically located at 1213 Coffee Rd, Modesto CA, 95355-4229. NPI Number Jack Robert Holt DDS has the Individual type.

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1629293618 NPI number is provided on an as is basis without warranty of any kind. 1629293618 is maintained by the National Plan & Provider Enumeration System. The contents of Jack Robert Holt DDS are for informational purposes only.