Provider Demographics
NPI:1578196242
Name:BRIAN OLVERA, DDS
Entity Type:Organization
Organization Name:BRIAN OLVERA, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JESSE
Authorized Official - Last Name:OLVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-869-3037
Mailing Address - Street 1:8327 DAVIS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4998
Mailing Address - Country:US
Mailing Address - Phone:562-869-3037
Mailing Address - Fax:562-861-0943
Practice Address - Street 1:8327 DAVIS ST STE 100
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4998
Practice Address - Country:US
Practice Address - Phone:562-869-3037
Practice Address - Fax:562-861-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental