Individual
JEFFERY BROUGHAM LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1647 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511-2803
(757) 953-8635
Mailing address
8150 SHORE DR APT 326, NORFOLK, VA 23518-2365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DENT.DE.70118772
WA
Other
Enumeration date
06/08/2026
Last updated
07/16/2026
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