# KOLB & KOLB DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376631572
- **Authorized official:** DR. PHILLIP W KOLB DDS (PARTNER)
- **Authorized official phone:** (812) 897-3470

## Contact information

- **Practice address:** 602 W LOCUST ST, BOONVILLE, IN 47601-0167
- **Practice address phone:** (812) 897-3470
- **Practice address fax:** (812) 897-0068
- **Mailing address:** PO BOX 167, 602 W LOCUST ST, BOONVILLE, IN 47601-0167
- **Mailing address phone:** (812) 897-3470
- **Mailing address fax:** (812) 897-0068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 08/22/2020