Individual
MR. STEVEN J. LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FAGD DDS
Contact information
Practice address
1088 N SKYLINE DR, IDAHO FALLS, ID 83402-1726
(208) 524-0870
(208) 524-0873
Mailing address
1088 N SKYLINE DR, IDAHO FALLS, ID 83402-1726
(208) 524-0870
(208) 524-0873
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1347
ID
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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