Provider Demographics
NPI:1144093113
Name:MAGNO, OLIVIA B (DDS)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:B
Last Name:MAGNO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:33378 ALVARADO NILES RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3199
Mailing Address - Country:US
Mailing Address - Phone:510-487-3912
Mailing Address - Fax:510-487-6566
Practice Address - Street 1:33378 ALVARADO NILES RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3199
Practice Address - Country:US
Practice Address - Phone:510-487-3912
Practice Address - Fax:510-487-6566
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA374471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice