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1346310414
KELLY JAMES LARSON
PRESCOTT VALLEY, AZ
NPI
1346310414
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: AZ D4296)
Enumeration Date
2006-11-08
Last Update Date
2007-07-08
Business Address
-- KELLY JAMES LARSON DDS
8086 E FLORENTINE RD
PRESCOTT VALLEY, AZ 86314-9422
Phone number: 928-772-8128
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Mailing Address
-- KELLY JAMES LARSON DDS
8086 E FLORENTINE RD
PRESCOTT VALLEY, AZ 86314-9422
Phone number: 928-772-8128
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