Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK OLSEN, D.D.S.
ActiveDR. MARK OLSEN, D.D.S. is a Pediatric Dentistry healthcare provider located in STAR, Idaho. NPI 1780816652 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · STAR, ID
Registration Details
- NPI Number
- 1780816652
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 11, 2009 (17.023425372519 yrs)
- Last Updated
- Feb 20, 2020
- Licenses
-
7371240-9921 (UT)D-5015-PD (ID)
Practice Information
- Address
-
12192 EVELY PINES LNSTAR, ID, 83669Browse ID providers · Browse ZIP 83669
- Phone
- 2089109000
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Pediatric Dentistry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.