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NPI Code Detail

MEDICARE: DR. SCOTT CORDELL OLSEN D.D.S.

MEDICARE: DR. SCOTT CORDELL OLSEN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1780MT

General Provider Information

NPI Number : 1841215167
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT CORDELL OLSEN D.D.S.
Provider Business Mailing Address
First Line : 115 S PACIFIC ST
Second Line :
City : DILLON
State : MT
Zip : 59725-2752
Country : US
Telephone Number : 406-683-2671
Fax Number : 406-496-6035
Provider Business Practice Location Address
First Line : 445 CENTENNIAL AVE
Second Line :
City : BUTTE
State : MT
Zip : 59701-2870
Country : US
Telephone Number : 406-496-6007
Fax Number : 406-496-6020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 04/24/2020

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