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MR. KENNETH NEIL HOLDEN LD

Dental Providers Denturist

Provider NPI: 1235359852

Provider Information:
MR. KENNETH NEIL HOLDEN LD
Gender: M
Not Sole Proprietor

Practice Location:
2300 NW KINGS BLVD  CORVALLIS, OR 97330 US
Tel: 541-754-0914  Fax: --

Business Mailing Address:
1241 OAK ST  EUGENE, OR 97401 US
Tel: --  Fax: --

NPI Information:
NPI: 1235359852
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122400000XDental Providers
Denturist
ORDTDO539081

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 122400000X

Type:

Classification:



Definition:



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