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General NPI Number Information
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NPI Number | 1013417112
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Entity Type | Individual
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Provider Name | NICHOLAS OLIVERI DMD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 02/15/2018
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Provider Practice Location Address
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Address Line | 37 AIRPORT RD
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City | HARTFORD
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State | CT
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Zip | 06114-2002
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Country | US
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Telephone | 860-296-0374
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Fax | 860-296-1971
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Provider Business Mailing Address
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Address Line | 37 AIRPORT RD
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City | HARTFORD
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State | CT
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Zip | 06114-2002
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Country | US
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Telephone | 860-296-0374
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Fax | 860-296-1971
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5160
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License Number State | CT
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