Individual
DR. JOHN MARK OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2621 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101-1948
(336) 724-5054
(336) 724-5033
Mailing address
2621 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101-1948
(336) 724-5054
(336) 724-5033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7312
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990168
—
NC
01
—
90168
BLUE CROSS BLUE SHIELD
NC
Enumeration date
01/15/2007
Last updated
03/07/2023
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