Individual
DR. PETER ERIC LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 292-5144
(614) 292-9472
Mailing address
PO BOX 182357, COLUMBUS, OH 43218-2357
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
18614
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.018614
OH
Other
Enumeration date
10/31/2006
Last updated
12/18/2019
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