Individual
MS. SHANNON MARIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
119 S STATE ST, SHELBY, MI 49455-1243
(231) 861-2130
(231) 861-4964
Mailing address
119 S STATE ST, SHELBY, MI 49455-1243
(231) 861-2130
(231) 861-4964
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902012812
MI
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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