Individual
DR. NATHAN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 E QUEEN CREEK RD, GILBERT, AZ 85298
(623) 400-3234
Mailing address
2546 E MELROSE ST, GILBERT, AZ 85297-7521
(480) 848-3110
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D011458
AZ
1223G0001X
General Practice Dentistry
8362005-9921
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D011458
AZ
Other
Enumeration date
03/14/2012
Last updated
05/08/2026
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