Healthcare Provider Details

I. General information

NPI: 1912687989
Provider Name (Legal Business Name): AMBER L OLSON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 S COLUMBIA ST
CHAPEL HILL NC
27514-4309
US

IV. Provider business mailing address

146 TOPSAIL LN APT 36
SMITHFIELD VA
23430-2770
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3737
  • Fax:
Mailing address:
  • Phone: 603-682-8865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number0401420282
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: