Individual
DR. MARC DENTICO-OLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
501 WASHINGTON ST STE 710, SAN DIEGO, CA 92103-2231
(619) 295-6774
(619) 295-6776
Mailing address
501 WASHINGTON ST STE 710, SAN DIEGO, CA 92103-2231
(619) 295-6774
(619) 295-6776
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
A143794
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
OMS109
CA
174400000X
Specialist
A143794
CA
Other
Enumeration date
06/11/2009
Last updated
06/19/2020
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