Individual
DR. GERALD DUANE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
418 BRIGGS AVE S, PARK RIVER, ND 58270-0662
(701) 284-6131
(701) 284-6901
Mailing address
PO BOX 662, PARK RIVER, ND 58270-0662
(701) 284-6131
(701) 284-6901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1355
ND
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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