# OLSON DENTAL GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225570013
- **Authorized official:** MATTHEW HALE (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (214) 702-0721

## Contact information

- **Practice address:** 6801 NW 39TH EXPY, SUITE A, BETHANY, OK 73008-2501
- **Practice address phone:** (405) 787-1946
- **Mailing address:** 2711 LBJ FWY, SUITE 122, DALLAS, TX 75234-7315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/09/2016
- **Last updated:** 11/09/2016