Provider Demographics
NPI:1801403936
Name:OLSSON & NIAZI PLLC
Entity Type:Organization
Organization Name:OLSSON & NIAZI PLLC
Other - Org Name:PUGET SOUND ENDODONTICS & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MOANA-MARIE
Authorized Official - Last Name:OLSSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-752-5511
Mailing Address - Street 1:3212 NW BYRON ST STE 108
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9154
Mailing Address - Country:US
Mailing Address - Phone:253-851-5544
Mailing Address - Fax:253-752-4442
Practice Address - Street 1:3212 NW BYRON ST STE 108
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9154
Practice Address - Country:US
Practice Address - Phone:253-851-5544
Practice Address - Fax:253-752-4442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty