Individual
DR. EBEN LARRABEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
230 N BROAD ST, 1ST FLOOR, PHILADELPHIA, PA 19102-1121
(215) 561-0562
Mailing address
207 N BROAD ST, PHILADELPHIA, PA 19107-1500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041019
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2016
Last updated
08/11/2016
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