Organization
OLSON DENTAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW HALE (AUTHORIZED REPRESENTATIVE)
(214) 702-0721
Entity
Organization
Contact information
Practice address
6801 NW 39TH EXPY, SUITE A, BETHANY, OK 73008-2501
(405) 787-1946
Mailing address
2711 LBJ FWY, SUITE 122, DALLAS, TX 75234-7315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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