Individual
BRADLEY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
148 DIVISION AVE, MORTON, WA 98356-9300
(360) 496-5101
(360) 496-4123
Mailing address
2114 MAIN ST STE 100-140, VANCOUVER, WA 98660-2674
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005129
WA
Other
Enumeration date
07/24/2006
Last updated
02/07/2023
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