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Individual

DR. SHIVA OLIAEI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
3503 W BROADWAY BLVD, SEDALIA, MO 65301-2124
(660) 460-4176
Mailing address
3503 W BROADWAY BLVD, SEDALIA, MO 65301-2124
(660) 460-4176

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2020042545
MO

Other

Enumeration date
12/29/2020
Last updated
04/01/2021
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