Holtzen, Richard Frederick John
Holtzen, Richard Frederick John is an individual health care provider with primary practice located at 805 S Reserve St , Missoula MT 59801-2104. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Dental Providers / Oral and Maxillofacial Surgery. Other Service Providers / Specialist is his primary health care specialty. Holtzen, Richard Frederick John can be contacted via phone (406) 381-6845.Contact Information
Primary practice address
805 S Reserve St
Missoula MT 59801-2104
Phone: (406) 381-6845
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 3332-S228 | Nevada |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 101008 | California |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 2431 | Montana |
Profile Details
| NPI number | 1588608616 |
|---|---|
| LBN Legal business name | Holtzen, Richard Frederick John |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Nov 2nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588608616 | NPPES |
| Nevada | MEDICAID | 002202076 |
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