Provider Demographics
NPI:1447470026
Name:JAMES HOLT, DDS, PA
Entity type:Organization
Organization Name:JAMES HOLT, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HANSFORD
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-488-2273
Mailing Address - Street 1:600 E. SOUTHLAKE BLVD.
Mailing Address - Street 2:#100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6254
Mailing Address - Country:US
Mailing Address - Phone:817-488-2273
Mailing Address - Fax:
Practice Address - Street 1:600 E SOUTHLAKE BLVD
Practice Address - Street 2:#100
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6254
Practice Address - Country:US
Practice Address - Phone:817-488-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty