William Edward Holley, DMD
Individual provider Active NPI General Practice Dentistry · Florala, AL
NPI 1316965718 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1316965718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2763 (AL)
- Practice address
- 24244 5TH Ave
Florala, AL 36442-3522 - Phone
- (334) 858-6816
- Fax
- (334) 858-6816
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 2763 | AL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2763 | AL | Yes |
Addresses
Primary practice location
24244 5TH Ave
Florala, AL 36442-3522
Mailing address
24244 5TH Ave
Florala, AL 36442-3522
Phone (334) 858-6816
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00564533 | Other | PA | UNITED CONCORDIA |
| 008402140 | Medicaid | AL | |
| 077447200 | Medicaid | FL | |
| 51093348 | Other | AL | BC/BS |
Other providers in Florala, AL
- Jessica Renee Fowler
- Frank Daniel
- Michael Wayne Frye
- Thomas Kevin Frye
- Geneval County Health Care Authority, Inc.
- Lori Ann Jackson
- Bobby Charles Kemp
- Heather Leonard
- Marmedica LLC
- David Andrew Marsh
All providers in Florala, AL · General Practice Dentistry in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 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.