Organization
MARTIN H OLESON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN H OLESON DDS (DOCTOR)
(605) 874-2230
Entity
Organization
Contact information
Practice address
210 SOUTH THIRD AVE., CLEAR LAKE, SD 57226-0559
(605) 874-2230
(605) 874-2675
Mailing address
PO BOX 559, CLEAR LAKE, SD 57226-0559
(605) 874-2230
(605) 874-2675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M-517
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802770
—
SD
Enumeration date
11/27/2006
Last updated
08/22/2020
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