Individual
DR. ELLIOT DAVID LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
7814 EXCELSIOR RD, BAXTER, MN 56425-8427
(218) 454-2400
Mailing address
6893 259TH AVE NE, STACY, MN 55079-3154
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D14244
MN
1223G0001X
General Practice Dentistry
D-4940
ID
1223G0001X
General Practice Dentistry
D14244
MN
Other
Enumeration date
06/19/2018
Last updated
10/04/2023
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