Provider Demographics
NPI:1811082969
Name:REYES MARIN, OLGA E (DMD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:E
Last Name:REYES MARIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1556
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664
Mailing Address - Country:US
Mailing Address - Phone:787-828-7716
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE FIGUERA STE 2B
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-1636
Practice Address - Country:US
Practice Address - Phone:787-828-7716
Practice Address - Fax:787-828-1725
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist