Organization
B. J. LARSON, D.D.S., P. S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD JOHN LARSON D.D.S. (PRESIDENT)
(360) 428-3565
Entity
Organization
Contact information
Practice address
2100 E SECTION ST STE 102, MOUNT VERNON, WA 98274-9132
(360) 428-3565
(360) 428-3593
Mailing address
2100 E SECTION ST STE 102, MOUNT VERNON, WA 98274-9132
(360) 428-3565
(360) 428-3593
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7195
WA
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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