Provider Demographics
NPI:1477680346
Name:OLIVER, ROBERT GAIL (DDS, MS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:GAIL
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:626 120TH AVE NE
Mailing Address - Street 2:B-210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3077
Mailing Address - Country:US
Mailing Address - Phone:425-453-1547
Mailing Address - Fax:425-646-0974
Practice Address - Street 1:626 120TH AVE NE
Practice Address - Street 2:B-210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3077
Practice Address - Country:US
Practice Address - Phone:425-453-1547
Practice Address - Fax:425-646-0974
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WADEOOOO68221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics