Provider Demographics
NPI:1972767200
Name:MICHAEL B. HOLBERT, D.D.S., P.C.
Entity type:Organization
Organization Name:MICHAEL B. HOLBERT, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BURKE
Authorized Official - Last Name:HOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-270-7824
Mailing Address - Street 1:2821 N PARHAM RD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4412
Mailing Address - Country:US
Mailing Address - Phone:804-270-7824
Mailing Address - Fax:804-270-6654
Practice Address - Street 1:2821 N PARHAM RD
Practice Address - Street 2:SUITE #201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4412
Practice Address - Country:US
Practice Address - Phone:804-270-7824
Practice Address - Fax:804-270-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014120601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty