Antonina B. Holmes, D.D.S.
Individual provider Active NPI General Practice Dentistry · Cottonport, LA
NPI 1316072002 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316072002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4535 (LA)
- Practice address
- 915 North Main St.
Cottonport, LA 71327-0655 - Phone
- (318) 876-3313
- Fax
- (318) 876-3313
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4535 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marlon L Holmes, DDS a Professional Corporation | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4535 | LA | Yes |
Addresses
Primary practice location
915 North Main St.
Cottonport, LA 71327-0655
Mailing address
PO Box 655
Cottonport, LA 71327-0655
Phone (318) 876-3313
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1845353 | Medicaid | LA |
Other providers in Cottonport, LA
- Galrob, Inc.
- Galrob, Inc.
- Jamie Garrett
- Chad Paul Gauthier
- Newell Erwin Gauthier Jr.
- Marlon L. Holmes
- Jarod Huffman
- Herndon Martin Jeansonne II
- Joey Lacombe
- Louisiana Health Care Practitioners LLC
All providers in Cottonport, LA · General Practice Dentistry in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.