Most Relevant Information
Provider Data
| NPI Number: | 1003360629 |
| Provider Name: | OLGA IVASHEVA D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | DEN.00202913 |
Most Important Dates
| Enumeration Date: | 08/11/2016 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
15301 WARREN SHINGLE RD
BEALE AFB
CA
959031907
Practice Location Phone/Fax
| Phone: | 5306344781 |
| Fax: |
Provider Mailing Location
15301 WARREN SHINGLE RD
BEALE AFB
CA
959031907
Provider Mailing Phone/Fax
| Phone: | 5306344781 |
| Fax: |