Provider Demographics
NPI:1588452908
Name:OLIVE TREE DENTAL CARE
Entity type:Organization
Organization Name:OLIVE TREE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YULIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVALOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-732-0503
Mailing Address - Street 1:5400 S BISCAYNE DR STE D
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-1932
Mailing Address - Country:US
Mailing Address - Phone:941-732-0503
Mailing Address - Fax:941-732-0503
Practice Address - Street 1:5400 S BISCAYNE DR STE D
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1932
Practice Address - Country:US
Practice Address - Phone:941-732-0503
Practice Address - Fax:941-732-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty