Individual
DR. BRIAN J LARSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
414 ALDER STREET, BROOKINGS, OR 97415
(541) 469-4013
(541) 469-9347
Mailing address
PO BOX 5600, BROOKINGS, OR 97415-0111
(541) 469-4013
(541) 469-9347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5965
OR
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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