Individual
DR. LEWIS RODNEY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6831 S CENTRAL AVE, PHOENIX, AZ 85042-5420
(602) 268-8881
Mailing address
6831 SOUTH CENTRAL AVE, PHOENIX, AZ 85042
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1170
AZ
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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