Edward Holliday, D.M.D.

Individual provider Active NPI General Practice Dentistry · Tupelo, MS

NPI 1548699861 · NPPES record last updated Nov 7, 2013

Key facts

NPI
1548699861
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2345-87 (MS)
Practice address
901 Garfield St
Tupelo, MS 38801-5737
Phone
(662) 844-6464
NPI assigned
Nov 7, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2345-87MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ed Holliday, D.M.D., Inc. General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2345-87 MS Yes

Addresses

Primary practice location

901 Garfield St
Tupelo, MS 38801-5737

Mailing address

901 Garfield St
Tupelo, MS 38801-5737
Phone (662) 844-6464

Other providers in Tupelo, MS

All providers in Tupelo, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.