Provider Demographics
NPI:1659924736
Name:ROYEA, OLIVIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:ROYEA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 RUNYAN DR
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2622
Mailing Address - Country:US
Mailing Address - Phone:310-987-1818
Mailing Address - Fax:
Practice Address - Street 1:1840 N OLIVE AVE STE 4
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2502
Practice Address - Country:US
Practice Address - Phone:310-987-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist