Provider Demographics
NPI:1154203834
Name:HOLD, NATHANIEL TYLER (DDS)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:TYLER
Last Name:HOLD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4575
Mailing Address - Country:US
Mailing Address - Phone:706-632-2085
Mailing Address - Fax:706-632-8685
Practice Address - Street 1:823 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4575
Practice Address - Country:US
Practice Address - Phone:706-632-8685
Practice Address - Fax:706-632-8685
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1238711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice