1851302285 NPI number — HOLT AND ASSOCIATES D.D.S., P. A.

Table of content: MS. LEILA GREEN LITTLE SLP, CLT (NPI 1013439983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851302285 NPI number — HOLT AND ASSOCIATES D.D.S., P. A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLT AND ASSOCIATES D.D.S., P. A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851302285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 JOHN HARDEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72076-3161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-982-4520
Provider Business Mailing Address Fax Number:
501-982-7450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 JOHN HARDEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72076-3161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-982-4520
Provider Business Practice Location Address Fax Number:
501-982-7450
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOLT
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
501-982-4520

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  3143 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1790709087 . This is a "INDIVIDUAL NPI NUMBER" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com