Organization
DR. BRIAN R. OLESON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN R. OLESON D.D.S. (OWNER)
(360) 877-5151
Entity
Organization
Contact information
Practice address
N. 68 LAKE CUSHMAN RD., HOODSPORT, WA 98548-0817
(360) 877-5151
(360) 877-5134
Mailing address
PO BOX 817, HOODSPORT, WA 98548-0817
(360) 877-5151
(360) 877-5134
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE00005463
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5042403
—
WA
Enumeration date
04/20/2007
Last updated
08/22/2020
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