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Individual

PHILLIP PETER OLSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
625 E 500 S, SUITE 202, BOUNTIFUL, UT 84010-3882
(801) 292-4141
Mailing address
625 E 500 S, SUITE 202, BOUNTIFUL, UT 84010-3882
(801) 292-4141

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6552335-8903
UT

Other

Enumeration date
02/13/2007
Last updated
10/25/2013
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