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Dr. Mark Olsen, DDS
Pediatric Dentist in Star, Idaho
NPI 1780816652

Mark Olsen is a Pediatric Dentist based in Star, ID and is specialized in Pediatric Dentistry. Mark Olsen practices in Star, ID and has the professional credentials of DDS. The NPI Number for Mark Olsen is 1780816652 and holds a License No. 7371240-9921 (Idaho).

The current practice location address for Mark Olsen is 12192 Evely Pines Ln, Star, ID and can be reached out via phone at 208-910-9000.

Location: 12192 Evely Pines Ln, Star, ID, 83669
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780816652
Provider Name
Mark Olsen
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
12192 Evely Pines Ln, Star, ID, 83669
Phone Number
208-910-9000
Fax Number
Provider Enumeration Date
08/11/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12192 Evely Pines Ln
City
Star
State
Idaho
Zip
83669
Phone Number
208-910-9000
Fax Number
person
Provider Business Mailing Address Details
Address
12192 Evely Pines Ln
City
Star
State
Idaho
Zip
83669
Phone Number
208-910-9000
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D-5015-PD (Idaho)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
7371240-9921 (Utah)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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