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Individual

ALEX JOHN OLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2602 S PICHER AVE, JOPLIN, MO 64804-1641
(417) 781-2220
Mailing address
2602 S PICHER AVE, JOPLIN, MO 64804-1641

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
172407
AK
1223P0221X
Pediatric Dentistry
Primary
2022008320
MO
1223P0221X
Pediatric Dentistry
61833
KS

Other

Enumeration date
02/27/2020
Last updated
04/12/2024
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