Individual
ROBERT L LARISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1214 S 4TH ST, SPRINGFIELD, IL 62703-2229
(217) 528-1502
(217) 528-7448
Mailing address
1214 S 4TH ST, SPRINGFIELD, IL 62703-2229
(217) 528-1502
(217) 528-7448
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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