Provider Demographics
NPI:1649712746
Name:THOMAS A.J. OLIVERO JR. DDS
Entity type:Organization
Organization Name:THOMAS A.J. OLIVERO JR. DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:AJ
Authorized Official - Last Name:OLIVERO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-794-2802
Mailing Address - Street 1:112 WALTON PARK LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3028
Mailing Address - Country:US
Mailing Address - Phone:804-794-2802
Mailing Address - Fax:804-797-6530
Practice Address - Street 1:112 WALTON PARK LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3028
Practice Address - Country:US
Practice Address - Phone:804-794-2802
Practice Address - Fax:804-797-6530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty