Organization
LARSEN-HASLEM DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAREN LYNN LARSEN DDS (OWNER)
(435) 781-2729
Entity
Organization
Contact information
Practice address
1214 W 500 S, VERNAL, UT 84078-2916
(435) 781-2729
(435) 781-2719
Mailing address
1214 W 500 S, VERNAL, UT 84078-2916
(435) 781-2729
(435) 781-2719
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3411869922
UT
261QD0000X
Dental Clinic/Center
65632849922
UT
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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