Organization
MARC R LARSON DDS MS A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC R LARSON DDS (AUTHORIZED OFFICIAL)
(951) 546-4008
Entity
Organization
Contact information
Practice address
6886 INDIANA AVE STE C, RIVERSIDE, CA 92506-4218
(951) 546-4008
Mailing address
6886 INDIANA AVE STE C, RIVERSIDE, CA 92506-4218
Taxonomy
Speciality
Code
Description
License number
State
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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