Organization
AFFORDABLE DENTURES- PEORIA, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL D. LARSEN DDS (PRACTICE OWNER)
(309) 689-1452
Entity
Organization
Contact information
Practice address
2807 W TOWNLINE RD, PEORIA, IL 61615-1557
(309) 689-1452
Mailing address
2807 W TOWNLINE RD, PEORIA, IL 61615-1557
(309) 689-1452
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.018482
IL
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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