Provider Demographics
NPI:1811244874
Name:JOSHUA A. HOLCOMB, D.D.S., P.L.L.C.
Entity type:Organization
Organization Name:JOSHUA A. HOLCOMB, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-221-1602
Mailing Address - Street 1:435 N BYHALIA RD STE 112
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3709
Mailing Address - Country:US
Mailing Address - Phone:901-221-1602
Mailing Address - Fax:
Practice Address - Street 1:435 N BYHALIA RD STE 112
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3709
Practice Address - Country:US
Practice Address - Phone:901-221-1602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSHUA A, HOLCOMB, D.D.S., P..L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN89911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty