Provider Demographics
NPI:1710698527
Name:STEVEN A OLIVER DMD LLC
Entity Type:Organization
Organization Name:STEVEN A OLIVER DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:251-342-3188
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:251-342-3188
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:251-342-3188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental