Individual
BRADLEY OLSEN
Active
Individual
BRADLEY OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDT
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT150
MN
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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