Individual
DR. KATIE MIETTUNEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6790015
WI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D13027
MN
Other
Enumeration date
11/29/2011
Last updated
11/26/2021
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