Provider Demographics
NPI:1548350838
Name:OLIVIA B. MAGNO, DMD, INC.
Entity type:Organization
Organization Name:OLIVIA B. MAGNO, DMD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-487-3912
Mailing Address - Street 1:33378 ALVARADO NILES RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3199
Mailing Address - Country:US
Mailing Address - Phone:510-487-3912
Mailing Address - Fax:510-487-6566
Practice Address - Street 1:33378 ALVARADO NILES RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3199
Practice Address - Country:US
Practice Address - Phone:510-487-3912
Practice Address - Fax:510-487-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty