MEDICARE: DR. STEVEN CARL OLSEN DDS

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
1	1223G0001X	General Practice Dentistry	104338	CO

General Provider Information

NPI Number	:	1982734067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN CARL OLSEN DDS

Provider Business Mailing Address
First Line	:	9085 E MINERAL CIR
Second Line	:	SUITE 220
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3462
Country	:	US
Telephone Number	:	303-798-1068
Fax Number	:	303-798-1538

Provider Business Practice Location Address
First Line	:	9085 E MINERAL CIR
Second Line	:	SUITE 220
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3462
Country	:	US
Telephone Number	:	303-798-1068
Fax Number	:	303-798-1538

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/11/2010

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