Provider Demographics
NPI:1063256436
Name:FINK, OLIVIA MARY (DMD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARY
Last Name:FINK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 HAINES AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3419
Mailing Address - Country:US
Mailing Address - Phone:937-474-3636
Mailing Address - Fax:
Practice Address - Street 1:1404 HAINES AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3419
Practice Address - Country:US
Practice Address - Phone:937-474-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.004813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist