Individual provider · Type 1 NPI
Mark Olsen, DDS
Pediatric Dentistry · Star, ID
NPI number
1780816652
Active
Practice location
12192 Evely Pines Ln
Star, ID 83669
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | 7371240-9921 (UT) |
| Pediatric Dentistry Primary | 1223P0221X | D-5015-PD (ID) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
About NPI 1780816652
Mark Olsen, DDS's National Provider Identifier is 1780816652, issued on Aug 11, 2009. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Star, ID. The record was last updated on Feb 20, 2020.