Provider Demographics
NPI:1346824380
Name:CAREFREE RESTORATIVE DENTAL ARTS, PLLC
Entity Type:Organization
Organization Name:CAREFREE RESTORATIVE DENTAL ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-488-9735
Mailing Address - Street 1:PO BOX 2268
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-2268
Mailing Address - Country:US
Mailing Address - Phone:480-488-9735
Mailing Address - Fax:480-575-1427
Practice Address - Street 1:7518 E ELBOW BND STE A1
Practice Address - Street 2:
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377-9605
Practice Address - Country:US
Practice Address - Phone:480-488-9735
Practice Address - Fax:480-575-1427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental