Individual
GARRY LEE OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
437 S KY 706, ISONVILLE, KY 41149-8966
(606) 738-6904
(606) 738-6904
Mailing address
437 S KY 706, ISONVILLE, KY 41149-8966
(606) 738-6904
(606) 738-6904
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6212
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60062122
—
KY
Enumeration date
01/09/2007
Last updated
08/16/2016
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