Individual
MRS. AMY L LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1400 LOMBARDI AVE, SUITE 50, GREEN BAY, WI 54304-3922
(920) 498-8877
(920) 498-8941
Mailing address
1408 SPRING ST, SOBIESKI, WI 54171-9717
(920) 826-6655
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4743
WI
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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