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Individual

DONALD E LARSON

Active
Find providers by NPI
Individual

DONALD E LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3551
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312746
UNITED CONCORDIA
ID
05
—
8061442
—
ID
01
—
CS9245
ID STATE BOARD OF PHARMACY
ID
Enumeration date
01/31/2011
Last updated
01/31/2011
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