Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 7709 | TX |
NPI | 1104099878 |
---|---|
Provider Name | Dr. Ferrin H. Holcomb |
First Address | Garland, TX 75043-1563 |
Second Address | Garland, TX 75043-1563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 02/04/2008 |