Organization
OLSON DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MICHAEL OLSON D.D.S. (OWNER)
(651) 788-7045
Entity
Organization
Contact information
Practice address
393 DUNLAP ST N, SUITE 308, SAINT PAUL, MN 55104-4200
(651) 788-7045
Mailing address
393 DUNLAP ST N, SUITE 308, SAINT PAUL, MN 55104-4200
(651) 788-7045
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8085
MN
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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