Individual
JENNI OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06032-1956
(860) 679-7600
Mailing address
15 FOREST ST, PLAINVILLE, CT 06062-2125
(678) 215-4661
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DGD.10215
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
14074
CT
Other
Enumeration date
06/03/2022
Last updated
06/11/2024
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