Individual
BENNETT PACKARD LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
223 140TH ST S, SUITE 800, TACOMA, WA 98444-4531
(253) 537-1559
(253) 536-5907
Mailing address
223 140TH ST S, SUITE 800, TACOMA, WA 98444-4531
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60384483
WA
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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