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1821210535
BRYCE ROBERT LARSEN
POCATELLO, ID
NPI
1821210535
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: ID D3894)
Enumeration Date
2007-05-03
Last Update Date
2007-07-08
Business Address
BRYCE ROBERT LARSEN D.M.D.
950 HOSPITAL WAY SUITE B
POCATELLO, ID 83201-2789
Phone number: 208-233-7007
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Mailing Address
BRYCE ROBERT LARSEN D.M.D.
950 HOSPITAL WAY SUITE B
POCATELLO, ID 83201-2789
Phone number: 208-233-7007
Copy
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