| Keith Holm Llc | |
|
13915 N Dysart Rd Ste A1 El Mirage AZ 85335-7333 | |
| (623) 444-6340 | |
| (623) 444-6350 |
| Full Name | Keith Holm Llc |
|---|---|
| Speciality | Dentist |
| Location | 13915 N Dysart Rd Ste A1, El Mirage, Arizona |
| Authorized Official Name and Position | Keith Holm (OWNER) |
| Authorized Official Contact | 6232519767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Holm Llc 13915 N Dysart Rd Ste A1 El Mirage AZ 85335-7333 Ph: (623) 444-6340 | Keith Holm Llc 13915 N Dysart Rd Ste A1 El Mirage AZ 85335-7333 Ph: (623) 444-6340 |
| NPI Number | 1417441767 |
|---|---|
| Provider Enumeration Date | 06/20/2018 |
| Last Update Date | 06/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417441767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D7138 (Arizona) | Primary |
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