Individual
DR. ZACK LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1093 HANCOCK RD, BULLHEAD CITY, AZ 86442-5904
(928) 758-5588
Mailing address
1093 HANCOCK RD, BULLHEAD CITY, AZ 86442-5904
(928) 758-5588
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008429
AZ
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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