Provider Demographics
NPI:1740334986
Name:OLIVER, RICHARD DENNIS (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DENNIS
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1220
Mailing Address - Country:US
Mailing Address - Phone:617-350-7774
Mailing Address - Fax:
Practice Address - Street 1:295 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1220
Practice Address - Country:US
Practice Address - Phone:617-350-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA147981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice