Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 13208 | OH |
NPI | 1003932427 |
---|---|
Provider Name | Dr. John George Holzbach |
First Address | Struthers, OH 44471 |
Second Address | Struthers, OH 44471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 08/07/2007 |