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General NPI Number Information
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NPI Number | 1366793317
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Entity Type | Individual
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Provider Name | CAROLINE SOLA-SADE OGUNWARE DMD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2012
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1930 N LA CANADA DR
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-4379
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Country | US
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Telephone | 804-306-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 N LA CANADA DR
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-4379
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Country | US
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Telephone | 804-306-0011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008562
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License Number State | AZ
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