Individual
OLGA JASINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 FORTINO BLVD, PUEBLO, CO 81008-1856
(214) 680-0443
(719) 362-4227
Mailing address
1640 FORTINO BLVD, PUEBLO, CO 81008-1856
(214) 680-0443
(719) 362-4227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS039464
PA
1223P0221X
Pediatric Dentistry
Primary
DS039464
PA
Other
Enumeration date
05/11/2013
Last updated
08/25/2016
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