Individual
MR. HARRISON LARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DA
Contact information
Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1565
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1565
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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