Individual
WILLIAM KIM LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
122 COLFAX AVE SW, WADENA, MN 56482-1470
(218) 631-4525
(218) 631-3998
Mailing address
122 COLFAX AVE SW, WADENA, MN 56482-1470
(218) 631-4525
(218) 631-3998
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12083
MN
Other
Enumeration date
10/06/2006
Last updated
07/16/2007
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