# J MARK OLIVER DDS PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306933635
- **Authorized official:** DR. JOHN MARK OLIVER DDS (PRESIDENT)
- **Authorized official phone:** (336) 724-5054

## Contact information

- **Practice address:** 2621 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101
- **Practice address phone:** (336) 724-5054
- **Practice address fax:** (336) 724-5033
- **Mailing address:** 2621 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101
- **Mailing address phone:** (336) 724-5054
- **Mailing address fax:** (336) 724-5033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7312 | NC | Yes |

## Other

- **Enumeration date:** 10/06/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8990168 | — | NC |