Organization
ST. PAUL ORAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE VICTOR OLSON D.D.S. (PRESIDENT)
(651) 451-1873
Entity
Organization
Contact information
Practice address
710 19TH AVE N, SUITE 300, SOUTH ST PAUL, MN 55075-1359
(651) 451-1873
(651) 451-8010
Mailing address
710 19TH AVE N, SUITE 300, SOUTH ST PAUL, MN 55075-1359
(651) 451-1873
(651) 451-8010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7933
MN
Other
Enumeration date
05/05/2006
Last updated
08/22/2020
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