Provider Demographics
NPI:1972853562
Name:HOLT, AMON EUGENE III (DDS)
Entity type:Individual
Prefix:DR
First Name:AMON
Middle Name:EUGENE
Last Name:HOLT
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:975 N MUR LEN RD STE A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1803
Mailing Address - Country:US
Mailing Address - Phone:913-415-2000
Mailing Address - Fax:913-415-2004
Practice Address - Street 1:975 N MUR LEN RD STE A
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1803
Practice Address - Country:US
Practice Address - Phone:913-415-2000
Practice Address - Fax:913-415-2004
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS610631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics