Individual
MR. TODD S LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8915 S 700 E STE 103, SANDY, UT 84070-2421
(801) 562-2147
(801) 569-1795
Mailing address
8915 S 700 E STE 103, SANDY, UT 84070-2421
(801) 562-2147
(801) 569-1795
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
360817-9922
UT
1223G0001X
General Practice Dentistry
DN014721
GA
Other
Enumeration date
02/23/2007
Last updated
11/12/2019
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