Provider Demographics
NPI:1710916309
Name:OLIVER, FAITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
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:PO BOX 1730
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29540-1730
Mailing Address - Country:US
Mailing Address - Phone:843-395-6112
Mailing Address - Fax:843-395-9062
Practice Address - Street 1:105 INDUSTRIAL WAY
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-6222
Practice Address - Country:US
Practice Address - Phone:843-395-6112
Practice Address - Fax:843-395-9062
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX3482Medicaid