SearchIdahoPediatric Dentistry

Mark Olsen, D.D.S

NPI 1780816652 · on the registry since 2009

Practice

Address
12192 Evely Pines Ln
Star, ID 83669
Phone
(208) 910-9000

Registry record

Primary taxonomy
Pediatric Dentistry
1223P0221X
Also registered as
General Practice Dentistry
Licence states on file
UT, ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-02-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho