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General NPI Number Information
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NPI Number | 1487521845
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Entity Type | Organization
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Legal Business Name | OLSON FAMILY DENTISTRY
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 4249 US-411 STE 3B STE 3B
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City | MADISONVILLE
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State | TN
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Zip | 37354
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Country | US
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Telephone | 423-420-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 545 RARITY BAY PKWY APT 206
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City | VONORE
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State | TN
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Zip | 37885-5381
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Country | US
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Telephone | 954-937-6718
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MANDY M OLSON
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Credential | DMD
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Telephone | 954-937-6718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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