Provider Demographics
NPI:1659152932
Name:EDWARD L OLCESE DDS PLLC
Entity Type:Organization
Organization Name:EDWARD L OLCESE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLCESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-872-7674
Mailing Address - Street 1:148 E MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-2202
Mailing Address - Country:US
Mailing Address - Phone:704-695-1588
Mailing Address - Fax:
Practice Address - Street 1:148 E MORGAN ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2202
Practice Address - Country:US
Practice Address - Phone:704-695-1588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty