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Individual

MRS. ANDREA KAY LARSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
210 MADISON ST, BEAVER DAM, WI 53916-2310
(920) 885-6066
Mailing address
210 MADISON ST, BEAVER DAM, WI 53916-2310
(920) 885-6066

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6701-15
WI

Other

Enumeration date
06/03/2011
Last updated
02/01/2022
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