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1003595166
OLIVIA GEORGIANNA NILLISSEN
SAN ANTONIO, TX
NPI
1003595166
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX ETN1063)
Enumeration Date
2023-07-17
Last Update Date
2023-08-11
Business Address
OLIVIA GEORGIANNA NILLISSEN DDS
8210 FLOYD CURL DRIVE, MSC 8103
SAN ANTONIO, TX 78229-3923
Phone number: 210-450-3273
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Mailing Address
OLIVIA GEORGIANNA NILLISSEN DDS
8210 FLOYD CURL DRIVE, MSC 8103
SAN ANTONIO, TX 78229-3923
Phone number: 210-450-3273
Copy
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