Provider Demographics
NPI:1144638289
Name:ROBERT A. HOLMES II, DMD.MS
Entity type:Organization
Organization Name:ROBERT A. HOLMES II, DMD.MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:II
Authorized Official - Credentials:DMD,MS
Authorized Official - Phone:205-824-2418
Mailing Address - Street 1:3021 LORNA RD STE 110
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4500
Mailing Address - Country:US
Mailing Address - Phone:205-824-2418
Mailing Address - Fax:205-824-2414
Practice Address - Street 1:3021 LORNA RD STE 110
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4500
Practice Address - Country:US
Practice Address - Phone:205-824-2418
Practice Address - Fax:205-824-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL 3767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1124160098Other122300000X DENTIST 3767 AL