Individual
DR. STEPHEN JOSEPH LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
612 ROCKDALE AVE, CINCINNATI, OH 45229-2919
(513) 352-4072
Mailing address
497 CINCINNATI BATAVIA PIKE, CINCINNATI, OH 45244-0249
(513) 528-1223
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
30022411
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2679981
—
OH
Enumeration date
01/03/2007
Last updated
07/08/2007
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