Provider Demographics
NPI:1205156478
Name:OLSEN, ADAM (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:OLSEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26671 E ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-6129
Mailing Address - Country:US
Mailing Address - Phone:720-460-1110
Mailing Address - Fax:
Practice Address - Street 1:1699 S COLORADO BLVD BLDG A STE J, DENVER, CO 80222
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT76826359922122300000X
CO2019741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist