Organization
TLARARSEN RDH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA LARSEN RDH (OWNER)
(262) 989-8949
Entity
Organization
Contact information
Practice address
6722 GREEN RIDGE DR, MT PLEASANT, WI 53406-5114
(262) 989-8949
Mailing address
6722 GREEN RIDGE DR, MT PLEASANT, WI 53406-5114
(262) 989-8949
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
9826-16
WI
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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