Provider Demographics
NPI:1346400710
Name:OLIVA, JAZMIN ESTHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAZMIN
Middle Name:ESTHER
Last Name:OLIVA
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:497 AVE EMILIANO POL
Mailing Address - Street 2:BOX 206 LA CUMBRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5602
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-765-5986
Practice Address - Street 1:UPR SCHOOL OF DENTAL MEDICINE RCM
Practice Address - Street 2:SUITE B 130 C TERRENOS DE CIENCIAS MEDICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-765-5986
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics