| Olean Dental Studio PLLC | |
|
21202 Olean Blvd Ste E2 Port Charlotte FL 33952-6723 | |
| (941) 629-3200 | |
| (941) 629-2113 |
| Full Name | Olean Dental Studio PLLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 21202 Olean Blvd Ste E2, Port Charlotte, Florida |
| Authorized Official Name and Position | Alberto Lopez De Castro Bolufer (OWNER) |
| Authorized Official Contact | 7867185655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olean Dental Studio PLLC 21202 Olean Blvd Ste E2 Port Charlotte FL 33952-6723 Ph: (941) 629-3200 | Olean Dental Studio PLLC 21202 Olean Blvd Ste E2 Port Charlotte FL 33952-6723 Ph: (941) 629-3200 |
| NPI Number | 1629729504 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 01/12/2022 |
| Certification Date | 01/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629729504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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