Provider Demographics
NPI:1376935411
Name:OLIVER, STEVEN ANDREW (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 BIT AND SPUR RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-2646
Mailing Address - Country:US
Mailing Address - Phone:615-419-3065
Mailing Address - Fax:
Practice Address - Street 1:4626 BIT AND SPUR RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-2646
Practice Address - Country:US
Practice Address - Phone:615-419-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL6204 C1122300000X
AL62041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist