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General NPI Number Information
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NPI Number | 1609890722
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Entity Type | Organization
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Legal Business Name | ROBERT W. OLIVER II, DDS, INC.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 25 E 21ST ST
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City | TULSA
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State | OK
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Zip | 74114-1109
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Country | US
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Telephone | 918-584-6448
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Fax | 918-582-4124
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Provider Business Mailing Address
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Address Line | 2105 E 15TH ST
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City | TULSA
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State | OK
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Zip | 74104-4613
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Country | US
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Telephone | 918-584-6448
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Fax | 918-582-4124
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT WESLEY OLIVER II
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Credential | D.D.S.
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Telephone | 918-584-6448
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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 | 3406
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License Number State | OK
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