Provider Demographics
NPI:1821169293
Name:OLIVER, WILLIAM THORNTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THORNTON
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 ST JOSEPH
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:TX
Mailing Address - Zip Code:78629
Mailing Address - Country:US
Mailing Address - Phone:830-672-2821
Mailing Address - Fax:830-672-1122
Practice Address - Street 1:833 ST JOSEPH
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629
Practice Address - Country:US
Practice Address - Phone:830-672-2821
Practice Address - Fax:830-672-1122
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice