Provider Demographics
NPI:1538246327
Name:OLIVER, WILLIAM GERALD (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GERALD
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 WINTON WAY
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301
Mailing Address - Country:US
Mailing Address - Phone:209-358-5485
Mailing Address - Fax:209-358-8446
Practice Address - Street 1:1095 WINTON WAY
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301
Practice Address - Country:US
Practice Address - Phone:209-358-5485
Practice Address - Fax:209-358-8446
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice