Provider Demographics
NPI:1336494954
Name:HOLMAN, LINDSAY ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ANN
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:ANN
Other - Last Name:RAYBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32280 FIVE MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-6112
Mailing Address - Country:US
Mailing Address - Phone:734-425-7010
Mailing Address - Fax:
Practice Address - Street 1:32280 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-6112
Practice Address - Country:US
Practice Address - Phone:734-425-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010206881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice