Individual
CLYDE S. LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
190 N CARBON AVE, PRICE, UT 84501-2474
(435) 637-0795
Mailing address
190 N CARBON AVE, PRICE, UT 84501-2474
(435) 637-0795
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
133591
UT
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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