Individual
DR. TIMOTHY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1600 HERITAGE LNDG, SUITE 210, SAINT PETERS, MO 63303-8489
(636) 441-3466
(636) 441-5330
Mailing address
1600 HERITAGE LNDG, SUITE 210, SAINT PETERS, MO 63303-8489
(636) 441-3466
(636) 441-5330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
013328
MO
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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