Individual
DR. JEFFRY JAMES LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19TH MEDICAL GROUP 1090 ARNOLD DRIVE, LITTLE ROCK AFB, AR 72099-0001
(501) 987-7304
Mailing address
19TH MEDICAL GROUP 1090 ARNOLD DRIVE, LITTLE ROCK AFB, AR 72099-0001
(501) 987-7304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10673
MN
Other
Enumeration date
08/22/2005
Last updated
12/03/2020
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