Provider Demographics
NPI:1376705327
Name:DELLVIEW DENTAL PA
Entity Type:Organization
Organization Name:DELLVIEW DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:OLEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-736-3420
Mailing Address - Street 1:1803 VANCE JACKSON RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4476
Mailing Address - Country:US
Mailing Address - Phone:210-736-3420
Mailing Address - Fax:210-736-3447
Practice Address - Street 1:1803 VANCE JACKSON RD
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4476
Practice Address - Country:US
Practice Address - Phone:210-736-3420
Practice Address - Fax:210-736-3447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18093261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental