Provider Demographics
NPI:1992137699
Name:HOLMES, ARONICA BOYLE (DMD)
Entity type:Individual
Prefix:
First Name:ARONICA
Middle Name:BOYLE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ARONICA
Other - Middle Name:YVETTE
Other - Last Name:BOYLE HOLMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:574 4TH AVE
Mailing Address - Street 2:APARTMENT 2G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6363
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:574 4TH AVE
Practice Address - Street 2:APARTMENT 2G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6363
Practice Address - Country:US
Practice Address - Phone:901-634-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist