Provider Demographics
NPI:1780633446
Name:DONTSOVA, OLGA (DDS)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:DONTSOVA
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 1:3900 CLARK RD SUITE Q
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:941-231-8121
Mailing Address - Fax:
Practice Address - Street 1:3900 CLARK RD SUITE Q
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-231-8121
Practice Address - Fax:941-231-8122
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD75901223G0001X
FLDM256451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice