Individual
JUDD ROBERT LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
57 N 2ND ST, CENTRAL POINT, OR 97502-2017
(541) 664-1406
Mailing address
1389 HIGHCREST DR, MEDFORD, OR 97504-9351
(541) 520-6089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7909
OR
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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