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General NPI Number Information
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NPI Number | 1588452908
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Entity Type | Organization
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Legal Business Name | OLIVE TREE DENTAL CARE
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 5400 S BISCAYNE DR STE D
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City | NORTH PORT
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State | FL
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Zip | 34287-1932
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Country | US
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Telephone | 941-732-0503
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Fax | 941-732-0503
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Provider Business Mailing Address
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Address Line | 5400 S BISCAYNE DR STE D
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City | NORTH PORT
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State | FL
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Zip | 34287-1932
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Country | US
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Telephone | 941-732-0503
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Fax | 941-732-0503
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Authorized Official
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Title or Position | OWNER
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Name | DR. YULIYA KOVALOVA
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Credential | DMD
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Telephone | 941-732-0503
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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 |
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License Number State |
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