Provider Demographics
NPI:1194941625
Name:HOLDEN, ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HOLDEN
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 1:7235 LOOKOUT RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8627
Mailing Address - Country:US
Mailing Address - Phone:303-530-7826
Mailing Address - Fax:
Practice Address - Street 1:3400 PENROSE PL
Practice Address - Street 2:SUITE 202
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1809
Practice Address - Country:US
Practice Address - Phone:303-442-5748
Practice Address - Fax:303-442-5749
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 31041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice