# OLSON FAMILY DENTAL PLLC

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

## Provider details

- **NPI number:** 1619586294
- **Authorized official:** DR. SAMUEL IVAN OLSON DDS (OWNER/DENTIST)
- **Authorized official phone:** (303) 886-2969

## Contact information

- **Practice address:** 11550 SHERIDAN BLVD STE 101, WESTMINSTER, CO 80020-3312
- **Practice address phone:** (720) 464-3901
- **Mailing address:** 12601 JULIAN ST, BROOMFIELD, CO 80020-5841
- **Mailing address phone:** (303) 886-2969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/29/2020
- **Last updated:** 07/29/2020