| NPI | 1558380972 | 
|---|---|
| Professional Name | DEENA A OLIVARES | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 21769) | 
| Additional Taxonomies | 122300000X Dentist (Licence: TX 21769) | 
| Enumeration Date | 2006-07-18 | 
| Last Update Date | 2021-06-01 |