Organization
OLEAN DENTAL STUDIO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERTO LOPEZ DE CASTRO BOLUFER DDS (OWNER)
(786) 718-5655
Entity
Organization
Contact information
Practice address
21202 OLEAN BLVD STE E2, PORT CHARLOTTE, FL 33952-6723
(941) 629-3200
(941) 629-2113
Mailing address
21202 OLEAN BLVD STE E2, PORT CHARLOTTE, FL 33952-6723
(941) 629-3200
(941) 629-2113
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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