Organization
GARY R. OLSON DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY OLSON (PRESIDENT)
(773) 488-5300
Entity
Organization
Contact information
Practice address
1319 W WESTGATE TER, CHICAGO, IL 60607-3304
(773) 488-5300
Mailing address
1319 W WESTGATE TER, CHICAGO, IL 60607-3304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/04/2008
Last updated
04/04/2008
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