Individual
DALE VICTOR OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26723OL
BCBS
MN
Enumeration date
10/11/2006
Last updated
07/08/2007
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