Provider Demographics
NPI:1437489085
Name:OLOWOYO, OLUWAKAYODE ADEBOLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLUWAKAYODE
Middle Name:ADEBOLA
Last Name:OLOWOYO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:205 WABASHA ST. S
Mailing Address - Street 2:SUIT 202
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1805
Mailing Address - Country:US
Mailing Address - Phone:651-293-8300
Mailing Address - Fax:651-293-8130
Practice Address - Street 1:606 24TH AVE S
Practice Address - Street 2:SUIT 202
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1455
Practice Address - Country:US
Practice Address - Phone:612-659-8689
Practice Address - Fax:612-659-8690
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND126561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice