Individual
DR. SAMUEL IVAN OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11550 SHERIDAN BLVD STE 101, WESTMINSTER, CO 80020-3312
(720) 464-3901
Mailing address
22249 HIGHWAY 52, HUDSON, CO 80642-9207
(303) 886-2969
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00204029
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2019
Last updated
07/29/2020
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