Individual
DR. MITCHELL SCOTT OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8636 N. WAYNE DR., HAYDEN, ID 83835
(208) 762-1555
(208) 262-3931
Mailing address
8636 N. WAYNE DR., HAYDEN, ID 83835
(208) 762-1555
(208) 262-3931
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
ADA073900774
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003553700
—
ID
Enumeration date
08/21/2006
Last updated
06/26/2023
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