Individual
DUSTIN LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2199 N MERRIT CRK LOOP, COEUR D ALENE, ID 83814-4949
(208) 665-7546
Mailing address
1899 TATE BLVD SE # 2110, HICKORY, NC 28602-4200
(828) 328-4449
(828) 328-4809
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2023-01420
NC
207N00000X
Dermatology Physician
M-13761
ID
Other
Enumeration date
04/08/2014
Last updated
05/08/2025
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