Individual
ANTHONY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 S 200 W, RICHMOND, UT 84333-1278
(435) 258-2301
Mailing address
251 SOUTH 530 EAST, SMITHFIELD, UT 84335
(435) 563-6196
(435) 258-5521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4938482-9922
UT
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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