Provider Demographics
NPI:1649327479
Name:OLIVER, MARCIA EDITA (DDS)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:EDITA
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 1:7150 CHESAPEAKE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LANDOVER HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2396
Mailing Address - Country:US
Mailing Address - Phone:301-577-6460
Mailing Address - Fax:301-577-6461
Practice Address - Street 1:7150 CHESAPEAKE RD STE 202
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-2396
Practice Address - Country:US
Practice Address - Phone:301-577-6460
Practice Address - Fax:301-577-6461
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice