| NPI | 1740655190 |
|---|---|
| Doing Business As | LARSON DENTAL |
| Entity Type | Organization |
| Authorized Contact | KELLY J LARSON Partner 928-772-8128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D04296) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: AZ D008229) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |