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NPI Code Detail

MEDICARE: DR. THOMAS A.J. OLIVERO JR. D.D.S.

MEDICARE: DR. THOMAS A.J. OLIVERO JR. D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401007470VA

General Provider Information

NPI Number : 1013070226
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS A.J. OLIVERO JR. D.D.S.
Provider Business Mailing Address
First Line : 112 WALTON PARK LN
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23114-3028
Country : US
Telephone Number : 804-794-2802
Fax Number : 804-794-6530
Provider Business Practice Location Address
First Line : 112 WALTON PARK LN
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23114-3028
Country : US
Telephone Number : 804-794-2802
Fax Number : 804-794-6530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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