Individual
MRS. RENEE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADT
Contact information
Practice address
401 JEWETT ST, MARSHALL, MN 56258-2605
(507) 532-3104
Mailing address
401 JEWETT ST, MARSHALL, MN 56258-2605
(507) 532-3104
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT53
MN
Other
Enumeration date
04/10/2017
Last updated
05/08/2026
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