Provider Demographics
NPI:1316993660
Name:KINNUNEN, OLIVER A (DDS)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:A
Last Name:KINNUNEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-9541
Mailing Address - Country:US
Mailing Address - Phone:863-465-9090
Mailing Address - Fax:863-465-9629
Practice Address - Street 1:330 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-9541
Practice Address - Country:US
Practice Address - Phone:863-465-9090
Practice Address - Fax:863-465-9629
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 148751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice