Individual
TYLER MICHAEL OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 GARFIELD ST, LANDER, WY 82520-3123
(307) 332-5297
Mailing address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(314) 833-2700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1676
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2023
Last updated
06/17/2024
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