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Individual

DR. BRUCE MERRILL LARSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS PC

Contact information

Practice address
240 N STATE ST # 21, MT PLEASANT, UT 84647-1107
(435) 462-2491
(435) 462-3999
Mailing address
240 N STATE ST # 21, MT PLEASANT, UT 84647-1107
(435) 462-2491
(435) 462-3999

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20-2063480
UT

Other

Enumeration date
05/14/2007
Last updated
07/08/2007
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