Organization
W.BRENT LARSEN, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W. BRENT LARSEN DDS (OWNER)
(501) 843-9306
Entity
Organization
Contact information
Practice address
3 TEMPLETON DR, CABOT, AR 72023-3821
(501) 843-9306
(501) 843-4251
Mailing address
3 TEMPLETON DR, CABOT, AR 72023-3821
(501) 843-9306
(501) 843-4251
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2976
AR
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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