# KEVIN P. TOLLIVER, D.D.S., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COSMETIC AND FAMILY DENTISTRY BY DR. KEVIN TOLLIVER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558478917
- **Authorized official:** DR. KEVIN PAUL TOLLIVER D.D.S. (PRESIDENT)
- **Authorized official phone:** (317) 571-5000

## Contact information

- **Practice address:** 8805 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46260-2332
- **Practice address phone:** (317) 571-5000
- **Practice address fax:** (317) 571-5010
- **Mailing address:** 8805 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46260-2332
- **Mailing address phone:** (317) 571-5000
- **Mailing address fax:** (317) 571-5010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12007532 | IN | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 08/22/2020