Provider Demographics
NPI:1043547664
Name:NASEA, OLGA SIMONA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:SIMONA
Last Name:NASEA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 21ST ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-3308
Mailing Address - Country:US
Mailing Address - Phone:715-360-4644
Mailing Address - Fax:
Practice Address - Street 1:3424 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-9001
Practice Address - Country:US
Practice Address - Phone:715-536-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7167-15122300000X
IL019028141122300000X
TX30032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist