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General NPI Number Information
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NPI Number | 1396489167
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Entity Type | Individual
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Provider Name | DOMINIQUE OLIVER DDS
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Gender | Female
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 600 E BAILEY BOSWELL RD STE 100
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City | SAGINAW
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State | TX
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Zip | 76131-3566
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Country | US
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Telephone | 682-285-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 8610 ROYAL MONTREAL DR
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City | ROWLETT
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State | TX
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Zip | 75089-4823
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Country | US
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Telephone | 469-288-3255
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 40763
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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