Whalio Doctors

NPI 1841613049

Leighton Roger Holley, DDS

Practitioner General Practice Dentistry Bonners Ferry, ID

Practice location

Address
6839 Cody St, Bonners Ferry, ID 83805-8613
Phone
(214) 558-3202
Mailing address
PO Box 3206, Bonners Ferry, ID 83805-3206

Registered specialties (4)

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence DEN-DEN-LIC-6079 (MT)
General Practice Dentistry
Dental Providers Taxonomy 1223G0001X Licence D-5203 (ID)
General Practice Dentistry
Dental Providers Taxonomy 1223G0001X Licence DDS-09864 (IA)
General Practice Dentistry
Dental Providers Taxonomy 1223G0001X Licence 1002437 (WI)

Registry record

NPI
1841613049
Entity type
Individual
Sex (as registered)
Male
NPI issued
24 Jan 2014
Record last updated
23 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.