Individual
MISS BREANNA ROSE OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
15188 N 75TH AVE, #280, PEORIA, AZ 85381-4723
(480) 730-1857
Mailing address
15188 N 75TH AVE, #280, PEORIA, AZ 85381-4723
(480) 730-1857
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7347
AZ
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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