| Kelly Hollis, Dds Pc | |
|
484 W Market St York PA 17401-3804 | |
| (717) 845-9664 | |
| (717) 845-9666 |
| Full Name | Kelly Hollis, Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 484 W Market St, York, Pennsylvania |
| Authorized Official Name and Position | Kelly M Hollis (OWNER) |
| Authorized Official Contact | 7178459664 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Hollis, Dds Pc 484 W Market St York PA 17401-3804 Ph: (717) 845-9664 | Kelly Hollis, Dds Pc 484 W Market St York PA 17401-3804 Ph: (717) 845-9664 |
| NPI Number | 1023176260 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3577992635 |
|---|---|
| Medicare Enrollment ID | O20200411000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023176260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS030780L (Pennsylvania) | Primary |
| Provider Name | Kelly M Hollis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447671805 PECOS PAC ID: 9638473655 Enrollment ID: I20200411000328 |
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