Organization
THOMAS H LARSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS HARTMAN LARSON DDS (PEDIATRIC DENTIST, OWNER)
(559) 431-9701
Entity
Organization
Contact information
Practice address
7780 N FRESNO ST, SUITE 105, FRESNO, CA 93720-2413
(559) 431-9701
(559) 431-9121
Mailing address
7780 N FRESNO ST, SUITE 105, FRESNO, CA 93720-2413
(559) 431-9701
(559) 431-9121
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
25928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B25928-01
—
CA
Enumeration date
03/12/2009
Last updated
03/12/2009
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