Provider Demographics
NPI:1942313622
Name:TATARKO, OLGA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:TATARKO
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 1:10371 PARKGLENN WAY
Mailing Address - Street 2:#250
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138
Mailing Address - Country:US
Mailing Address - Phone:303-840-1900
Mailing Address - Fax:303-840-3025
Practice Address - Street 1:10371 PARKGLENN WAY
Practice Address - Street 2:#250
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138
Practice Address - Country:US
Practice Address - Phone:303-840-1900
Practice Address - Fax:303-840-3025
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7759122300000X
MN9622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist