# JUSTIN OLSEN DDS PLLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mission Oral Surgery and Implant Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790668713
- **Authorized official:** DR. JUSTIN OLSEN DDS (OWNER)
- **Authorized official phone:** (435) 512-3442

## Contact information

- **Practice address:** 15600 SAN PEDRO AVE STE 107, SAN ANTONIO, TX 78232-3738
- **Practice address phone:** (210) 490-4044
- **Practice address fax:** (210) 490-3512
- **Mailing address:** 15600 SAN PEDRO AVE STE 107, SAN ANTONIO, TX 78232-3738
- **Mailing address phone:** (210) 490-4044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2025
- **Last updated:** 07/30/2025