Provider Demographics
NPI:1083621817
Name:OLIVER, WILLIAM LAURENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LAURENCE
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 HERITAGE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5983
Mailing Address - Country:US
Mailing Address - Phone:682-738-3029
Mailing Address - Fax:
Practice Address - Street 1:5005 HERITAGE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5983
Practice Address - Country:US
Practice Address - Phone:682-738-3029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2011-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13790122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist