Ivan Daniel Olsen DDS

NPI 1003886425 - Dentist - 1223G0001X

NPI Details
NPI 1003886425
Gender Male
Enumeration Date 01/26/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
104 MUNICIPAL LANE
PAW PAW MI, 49079-0172, US
Phone (269) 657-4001
Fax (269) 657-4001
Business Location
PO BOX 172
PAW PAW MI, 49079-0172, US
Phone (269) 657-4001
Fax (269) 657-4001
Toxanomy
Taxonomy Code 1223G0001X
License State Michigan
License Number 2901009329
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According to our database, Dr. Ivan Daniel Olsen DDS NPI is 1003886425, taxonomy code is 1223G0001X and license number is 2901009329, license state is located at Michigan. Ivan Daniel Olsen DDS physically located at 104 Municipal Lane, Paw Paw MI, 49079-0172. NPI Number Ivan Daniel Olsen DDS has the Individual type.

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1003886425 NPI number is provided on an as is basis without warranty of any kind. 1003886425 is maintained by the National Plan & Provider Enumeration System. The contents of Ivan Daniel Olsen DDS are for informational purposes only.