Individual
MS. LAURA LEE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
27201 HIGHWAY 189, BLUE JAY, CA 92317
(909) 337-6670
Mailing address
PO BOX 898, RUNNING SPRINGS, CA 92382-0898
(909) 867-1145
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
16999
CA
126900000X
Dental Laboratory Technician
16999
CA
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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