Provider Demographics
NPI:1346571973
Name:OLSON, AARON MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MICHAEL
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 1:105 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-3108
Mailing Address - Country:US
Mailing Address - Phone:435-723-8913
Mailing Address - Fax:
Practice Address - Street 1:105 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3108
Practice Address - Country:US
Practice Address - Phone:435-723-8913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT75351011223G0001X
AZ79011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice