Individual
DR. DOUGLAS KEITH LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
42 W CAMPBELL AVE STE 204, CAMPBELL, CA 95008-1042
(408) 374-6160
(408) 374-6474
Mailing address
42 W CAMPBELL AVE STE 204, CAMPBELL, CA 95008-1042
(408) 374-6160
(408) 374-6474
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30698
CA
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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