Provider Demographics
NPI:1225121478
Name:OLSON, HEATHER JEAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:JEAN
Last Name:OLSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 TOWN BANK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-2942
Mailing Address - Country:US
Mailing Address - Phone:609-886-5255
Mailing Address - Fax:609-886-7051
Practice Address - Street 1:204 TOWN BANK RD
Practice Address - Street 2:
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-2942
Practice Address - Country:US
Practice Address - Phone:609-886-5255
Practice Address - Fax:609-886-7051
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022789001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice