Provider Demographics
NPI:1326067497
Name:LAWRENCE J. OLIVEIRA, D.D.S., P.C.
Entity Type:Organization
Organization Name:LAWRENCE J. OLIVEIRA, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GWOZDZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-758-3366
Mailing Address - Street 1:2856 ACUSHNET AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1618
Mailing Address - Country:US
Mailing Address - Phone:508-998-1232
Mailing Address - Fax:
Practice Address - Street 1:107 FAIRHAVEN RD
Practice Address - Street 2:SUITE D
Practice Address - City:MATTAPOISETT
Practice Address - State:MA
Practice Address - Zip Code:02739-1459
Practice Address - Country:US
Practice Address - Phone:508-758-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty