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Individual

DR. EDGARDO E OLIVENCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
URB. SANFELIZ CALLE 5 #2, COROZAL, PR 00784
(787) 859-4514
(787) 793-5539
Mailing address
FLORENCIA ST. #E-12, EXT. VILLA CAPARRA, GUAYNABO, PR 00966
(787) 793-7175
(787) 793-5539

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
876
PR

Other

Enumeration date
10/31/2006
Last updated
07/08/2007
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