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Organization
B. J. LARSON, D.D.S., P. S.
Active
Organization
B. J. LARSON, D.D.S., P. S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD JOHN LARSON D.D.S. (PRESIDENT)
(360) 428-3565
Entity
Organization
Contact information
Practice address
2100 E SECTION ST STE 102, MOUNT VERNON, WA 98274-9132
(360) 428-3565
(360) 428-3593
Mailing address
2100 E SECTION ST STE 102, MOUNT VERNON, WA 98274-9132
(360) 428-3565
(360) 428-3593
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7195
WA
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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