NIELS WILLARD LARSEN

POCATELLO, ID
NPI1770796070
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D-1599)
Enumeration Date2007-05-07
Last Update Date2007-07-08
Business Address
-- NIELS WILLARD LARSEN D.D.S.
950 HOSPITAL WAY SUITE B
POCATELLO, ID 83201-2789
Phone number: 208-233-7007
Mailing Address
-- NIELS WILLARD LARSEN D.D.S.
950 HOSPITAL WAY SUITE B
POCATELLO, ID 83201-2789
Phone number: 208-233-7007
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