Individual provider · Type 1 NPI
Randolph Holly, DDS
Oral and Maxillofacial Surgery (Dentist) · Endicott, NY
NPI number
1871663427
Active
Practice location
1003 Monroe Street
Endicott, NY 13760
Fax (607) 757-9375
Mailing address
1003 Monroe St
Endicott, NY 13760-5221
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 0369901 (NY) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
About NPI 1871663427
Randolph Holly, DDS's National Provider Identifier is 1871663427, issued on Nov 9, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Endicott, NY. The record was last updated on Jul 9, 2007.