Provider Demographics
NPI:1437214442
Name:OLIVETTI, JOSEPH MICHAEL (DDS MAGD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:OLIVETTI
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MARKET PLAZA WALL
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5679
Mailing Address - Country:US
Mailing Address - Phone:717-795-3997
Mailing Address - Fax:717-795-5494
Practice Address - Street 1:2 MARKET PLAZA WALL
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5679
Practice Address - Country:US
Practice Address - Phone:717-795-3997
Practice Address - Fax:717-795-5494
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018021L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist