Organization
LARSEN FAMILY DENTAL S.C.
Active
Other names
Mark Barrette DDS, S.C.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA K LARSEN DDS (OWNER)
(920) 885-6066
Entity
Organization
Contact information
Practice address
215 N. SPRING STREET, BEAVER DAM, WI 53916
(920) 885-6066
(920) 885-6192
Mailing address
215 N. SPRING ST., BEAVER DAM, WI 53916
(920) 885-6066
(920) 885-6192
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
500159515
WI
Other
Enumeration date
05/12/2006
Last updated
08/23/2013
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