ETHAN JAMES LARSON

PUYALLUP, WA
NPI1083975759
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist Orthodontics and Dentofacial Orthopedics
(Licence: WA  DE60199084)
Enumeration Date2012-05-30
Last Update Date2012-05-30
Business Address
DR. ETHAN JAMES LARSON D.M.D. M.S.
210 4TH AVE SW
PUYALLUP, WA 98371-5863
Phone number: 253-848-4537
Mailing Address
DR. ETHAN JAMES LARSON D.M.D. M.S.
210 4TH AVE SW
PUYALLUP, WA 98371-5863
Phone number: 253-848-4537
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