Individual
JUSTIN OLLERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1501 NE 10TH AVE, PAYETTE, ID 83661-5422
(208) 642-9379
Mailing address
1431 S MAIN ST, PAYETTE, ID 83661-5352
(208) 642-7364
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3181518
ID
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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