RICHARD D HOLLEY, DDS, PC
Dentist at Tatum Blvd, Phoenix, AZ

License number
Arizona D4573
Category
Ambulatory Health
Type
Dental
Owner
Name: DR. RICHARD DWIGHT HOLLEY JR. DDS
Title: PRESIDENT
Phone: (480) 473-3111
Address
Address
20950 N Tatum Blvd #350, Phoenix, AZ 85050
National Provider ID: 1952596058
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RICHARD D. HOLLEY, D.D.S., PC

20950 N Tatum Blvd #350, Phoenix, AZ 85050

Status:
Inactive
Registration:
May 18, 2004
Inactive since:
Oct 23, 2009
State ID:
-1133913-6
Expiration:
Perpetual
President:
Richard Holley (President), 5490 W Melinda Ln, Glendale, AZ 85308 (Physical)
Agent:
Richard D Holley,20950 N Tatum Blvd #350, Phoenix, AZ 85050 (Physical)
Business type:
Health Care

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