Provider Demographics
NPI:1154171577
Name:TOLLIVER, HUNTER JO (DDS)
Entity type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:JO
Last Name:TOLLIVER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31771 US HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:RINGLING
Mailing Address - State:OK
Mailing Address - Zip Code:73456-8025
Mailing Address - Country:US
Mailing Address - Phone:580-264-0865
Mailing Address - Fax:
Practice Address - Street 1:4441 DIPLOMACY DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5910
Practice Address - Country:US
Practice Address - Phone:580-264-0865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2230741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice