Holman, Brent L

Holman, Brent L is an individual health care provider with primary practice located at 2538 University Dr S Suite A, Fargo ND 58103-5737. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Holman, Brent L can be contacted via phone (701) 232-1148.

Contact Information

Primary practice address
2538 University Dr S Suite A Fargo ND 58103-5737
Phone: (701) 232-1148
Fax: (701) 232-8907
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 1587 North Dakota

Profile Details

NPI number 1528121258
LBN Legal business name Holman, Brent L
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 17th, 2006
Last updated May 1st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528121258 NPPES
North Dakota Other 26296 BLUE CROSS BLUE SHIELD
North Dakota Other 330 BLUE CROSS BLUE SHIELD
North Dakota Other 91799110 BLUE CROSS BLUE SHIELD
North Dakota MEDICAID 370720200 BLUE CROSS BLUE SHIELD
North Dakota MEDICAID 40633 BLUE CROSS BLUE SHIELD

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