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Individual
DR. PETER ERIC LARSEN
Active
Individual
DR. PETER ERIC LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
18614
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.018614
OH
Other
Enumeration date
10/31/2006
Last updated
12/18/2019
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