Provider Demographics
NPI:1104129477
Name:MCIVER, HOLLY PAVLICK (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:PAVLICK
Last Name:MCIVER
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5864 KINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2644
Mailing Address - Country:US
Mailing Address - Phone:281-220-8444
Mailing Address - Fax:281-220-8447
Practice Address - Street 1:5864 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-2644
Practice Address - Country:US
Practice Address - Phone:281-220-8444
Practice Address - Fax:281-220-8447
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist