Provider Demographics
NPI:1336342658
Name:OLIVER-RAINEY, VACORA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:VACORA
Middle Name:L
Last Name:OLIVER-RAINEY
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 6526
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22403-6526
Mailing Address - Country:US
Mailing Address - Phone:540-318-8708
Mailing Address - Fax:540-318-8710
Practice Address - Street 1:1229 GARRISONVILLE RD
Practice Address - Street 2:SUITE #101
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-3655
Practice Address - Country:US
Practice Address - Phone:540-318-8708
Practice Address - Fax:540-318-8710
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice