Individual
ERIC STEVEN LAROUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
501 W HARRIE ST, NEWBERRY, MI 49868-1226
(906) 293-8291
Mailing address
501 W HARRIE ST, P.O.BOX 504, NEWBERRY, MI 49868-1226
(906) 293-8291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901015700
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901015700
STATE DENTAL LICENSE NUMB
MI
Enumeration date
04/19/2007
Last updated
07/08/2007
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