Provider Demographics
NPI:1033651351
Name:DIGITAL DENTAL STUDIO
Entity Type:Organization
Organization Name:DIGITAL DENTAL STUDIO
Other - Org Name:DR JAMES R. OLIVARI
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST/MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLIVARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:551-264-9000
Mailing Address - Street 1:284 NORTH FRANKLIN TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446
Mailing Address - Country:US
Mailing Address - Phone:551-264-9000
Mailing Address - Fax:551-264-9001
Practice Address - Street 1:284 NORTH FRANKLIN TURNPIKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446
Practice Address - Country:US
Practice Address - Phone:551-264-9000
Practice Address - Fax:551-264-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015131011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty