Olivia Georgianna Nillissen, DDS
Student in an Organized Health Care Education/Training Program in San Antonio, TX. Individual provider (NPI-1).
NPI number1003595166
StatusActive
Last updated in NPPESAug 11, 2023
Details
- NPI
- 1003595166
- Entity type
- Individual (NPI-1)
- Name
- Olivia Georgianna Nillissen
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 17, 2023
- Certification date
- Aug 11, 2023
- Last updated
- Aug 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | ETN1063 | TX | Yes |
Practice location
8210 Floyd Curl Drive, Msc 8103San Antonio, TX 78229-3923
Phone 210-450-3273 · Fax 210-450-2223
Mailing address
8210 Floyd Curl Drive, Msc 8103San Antonio, TX 78229-3923
Phone 210-450-3273 · Fax 210-450-2223
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All 1,856 Student in an Organized Health Care Education/Training Program providers in San Antonio · All 48,677 providers in San Antonio
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