Individual
TROY OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1195 W MASON ST, GREEN BAY, WI 54303-2045
(920) 498-3633
Mailing address
1195 W MASON ST, GREEN BAY, WI 54303-2045
(920) 498-3633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001074-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6001074-15
DENTAL LICENSE
WI
Enumeration date
08/23/2022
Last updated
08/23/2022
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