| NPI | 1730757691 |
|---|---|
| Doing Business As | DR. JACK HOLLY, DDS |
| Entity Type | Organization |
| Authorized Contact | REBECCA ARNOLD Revenue Manager 423-247-8172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-07-23 |