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Organization
FIRST AVENUE DENTAL, PA
Active
Organization
FIRST AVENUE DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUZETTE A OLSON D.D.S. (DENTIST)
(320) 632-8113
Entity
Organization
Contact information
Practice address
74 1ST AVE SE, LITTLE FALLS, MN 56345-3042
(320) 632-8113
(320) 632-5584
Mailing address
74 1ST AVE SE, LITTLE FALLS, MN 56345-3042
(320) 632-8113
(320) 632-5584
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11599
MN
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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