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Individual

STEPHANIE OLSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2864 S CIRCLE DR, STE 450, COLORADO SPRINGS, CO 80906
(719) 776-8850
Mailing address
2864 S CIRCLE DR, STE 450, COLORADO SPRINGS, CO 80906

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
906416
CO
124Q00000X
Dental Hygienist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49507273
CO
Enumeration date
08/09/2013
Last updated
08/22/2018
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