Provider Demographics
NPI:1326291675
Name:RODRIGUEZ- VALLE, OLGA K (DMD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:K
Last Name:RODRIGUEZ- VALLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 N DURANGO DR STE 420
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4598
Mailing Address - Country:US
Mailing Address - Phone:702-518-5151
Mailing Address - Fax:702-799-9831
Practice Address - Street 1:6850 N DURANGO DR STE 420
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4598
Practice Address - Country:US
Practice Address - Phone:702-518-5151
Practice Address - Fax:702-799-9831
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV57421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice