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Individual

DR. LEWIS C LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
400 CELEBRATION PL, A-260, CELEBRATION, FL 34747-4970
(407) 566-2222
(407) 566-1650
Mailing address
741 FRONT ST, #310, CELEBRATION, FL 34747-4991
(407) 566-2222
(407) 566-1650

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN 7443
FL

Other

Enumeration date
03/01/2007
Last updated
07/08/2007
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