Provider Demographics
NPI:1386722239
Name:OLIVEIRA, DANIEL LEE (DDS GENERAL DENTISTR)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LEE
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:DDS GENERAL DENTISTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 S GARFIELD SOUTH
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444
Mailing Address - Country:US
Mailing Address - Phone:253-531-1431
Mailing Address - Fax:253-536-2938
Practice Address - Street 1:422 S GARFIELD SOUTH
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444
Practice Address - Country:US
Practice Address - Phone:253-531-1431
Practice Address - Fax:253-536-2938
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
WA63811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice