Healthcare Provider Details

I. General information

NPI: 1780603621
Provider Name (Legal Business Name): BARBARA F OLSON RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COURT ST SUITE 270
LEBANON NH
03766-1358
US

IV. Provider business mailing address

3 ALDRICH AVE
WEST LEBANON NH
03784-1640
US

V. Phone/Fax

Practice location:
  • Phone: 603-448-1830
  • Fax: 603-448-1826
Mailing address:
  • Phone: 603-298-5399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1054
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: