Provider Demographics
NPI:1134314594
Name:OLIVER, JAMES DEWITT JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEWITT
Last Name:OLIVER
Suffix:JR
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 1:167 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2744
Mailing Address - Country:US
Mailing Address - Phone:732-548-6666
Mailing Address - Fax:732-494-0119
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2744
Practice Address - Country:US
Practice Address - Phone:732-548-6666
Practice Address - Fax:732-494-0119
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100917000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist