Individual
MRS. ALICIA MARIE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
140 WASHINGTON ST, GENEVA, NY 14456-2839
(315) 789-7922
Mailing address
3231 BRAND RD, CLYDE, NY 14433-9728
(315) 604-7257
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
031238
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031238
—
NY
Enumeration date
07/08/2022
Last updated
07/08/2022
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