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General NPI Number Information
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NPI Number | 1447819784
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Entity Type | Individual
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Provider Name | OLGA A SANIUKOVICH DMD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 08/16/2025
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Provider Practice Location Address
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Address Line | 1650 45TH ST S STE 108
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City | FARGO
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State | ND
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Zip | 58103-3247
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Country | US
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Telephone | 701-526-4652
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Fax | 701-282-2572
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Provider Business Mailing Address
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Address Line | 3626 E HAMILTON KY
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-6436
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Country | US
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Telephone | 727-505-3720
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 12014626A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | DN24170
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License Number State | FL
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