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General NPI Number Information
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NPI Number | 1720660004
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Entity Type | Individual
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Provider Name | MACKENZIE OLIVIERI DDS
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Gender | Female
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 6900 SENECA ST
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City | ELMA
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State | NY
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Zip | 14059-9522
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Country | US
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Telephone | 716-652-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 1497 ABBOTT RD
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City | LACKAWANNA
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State | NY
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Zip | 14218-2057
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Country | US
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Telephone | 716-825-5020
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12672
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 062973
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License Number State | NY
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