Individual
DR. MATTHEW GIBB OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
(435) 773-8566
Mailing address
1406 CHESTNUT ST, SENECA, MO 64865-9261
(435) 773-8566
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2024014437
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2023
Last updated
04/23/2024
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