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DR. SALLY GRANT HOLLIDAY DMD, MS

Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental Providers

Registrant NPI Number: 1881844082

Individual Registrant:
DR. SALLY GRANT HOLLIDAY DMD, MS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
11 BUSINESS CENTER DR SUITE 105 EASTANOLLEE, GA 30538-3254 US
Tel: 864-723-5220  Fax: --

Contact information for business:
105 REMUS DR  WALHALLA, SC 29691-4927 US
Tel: 864-723-5220  Fax: --

Registration Information:
NPI: 1881844082
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223X0400XDental Providers
Dentist
Orthodontics and Dentofacial Orthopedics
GADN013947
N1223X0400XDental Providers
Dentist
SC4621

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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