Provider Demographics
NPI:1487828075
Name:CULVER, OLIVER PAUL III (DMD)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:PAUL
Last Name:CULVER
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6324
Mailing Address - Country:US
Mailing Address - Phone:843-871-1993
Mailing Address - Fax:
Practice Address - Street 1:202 S MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6324
Practice Address - Country:US
Practice Address - Phone:843-871-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ29791Medicaid