Provider Demographics
NPI:1144399981
Name:OLSON, WILLIAM HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOWARD
Last Name:OLSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 709
Mailing Address - Street 2:101 2ND ST SE
Mailing Address - City:PIPESTONE
Mailing Address - State:MN
Mailing Address - Zip Code:56164
Mailing Address - Country:US
Mailing Address - Phone:507-825-5403
Mailing Address - Fax:507-825-6413
Practice Address - Street 1:101 2ND ST SE
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164
Practice Address - Country:US
Practice Address - Phone:507-825-5403
Practice Address - Fax:507-825-6413
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN67961223G0001X
SDD6251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice