Individual
DR. GARY STANFORD OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
403 NW 4TH ST, ALEDO, IL 61231
(309) 582-2022
(309) 582-2022
Mailing address
PO BOX 10, ALEDO, IL 61231
(309) 582-2022
(309) 582-2022
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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