Individual
DR. KATIE MIETTUNEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
2966 MEADOWLARK LANE, ALTOONA, WI 54720
(715) 514-3333
Mailing address
2966 MEADOWLARK LANE, ALTOONA, WI 54720
(715) 514-3333
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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