Organization
KIM F LARSON
Active
Other names
Larson Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MARIE SODD (OFFICE MANAGER)
(612) 789-2853
Entity
Organization
Contact information
Practice address
1632 WASHINGTON ST NE, MINNEAPOLIS, MN 55413-1336
(612) 789-2853
(612) 789-9413
Mailing address
1632 WASHINGTON ST NE, MINNEAPOLIS, MN 55413-1336
(612) 789-2853
(612) 789-9413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/29/2006
Last updated
08/22/2020
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