Provider Demographics
NPI:1538554944
Name:HOLMES, REBECCA H (DMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:H
Last Name:HOLMES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 NE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2321
Mailing Address - Country:US
Mailing Address - Phone:864-963-4410
Mailing Address - Fax:864-962-0631
Practice Address - Street 1:512 NE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2321
Practice Address - Country:US
Practice Address - Phone:864-963-4410
Practice Address - Fax:864-962-0631
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8422122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist