Provider Demographics
NPI:1992997811
Name:HOLLOMAN, ASHLEY ADAMS (DDS)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ADAMS
Last Name:HOLLOMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5222 N. PORTLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-947-1525
Mailing Address - Fax:405-947-6716
Practice Address - Street 1:5222 N. PORTLAND AVENUE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-947-1525
Practice Address - Fax:405-947-6716
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice