Provider Demographics
NPI:1699205583
Name:OLSON, ANNE KATHRYN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:KATHRYN
Last Name:OLSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:KATHRYN
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2835 SUMMER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3812
Mailing Address - Country:US
Mailing Address - Phone:901-372-7283
Mailing Address - Fax:
Practice Address - Street 1:2835 SUMMER OAKS DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3812
Practice Address - Country:US
Practice Address - Phone:901-372-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015467122300000X
TN10962122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist