Organization
DANIEL J. OLSON DDS PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J OLSON DDS (OWNER)
(541) 673-4152
Entity
Organization
Contact information
Practice address
2510 NW MEDICAL PARK DR, ROSEBURG, OR 97470-5510
(541) 673-4152
(541) 673-4156
Mailing address
2510 NW MEDICAL PARK DR, ROSEBURG, OR 97470-5510
(541) 673-4152
(541) 673-4156
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7394
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133665
MEDICARE GROUP NUMBER
OR
Enumeration date
05/29/2008
Last updated
05/29/2008
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