Organization
LARSON ORTHODONTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW EVANS LARSON DDS, MS (OWNER)
(651) 366-9754
Entity
Organization
Contact information
Practice address
431 E CLAIREMONT AVE, SUITE B, EAU CLAIRE, WI 54701-3685
(715) 514-3333
(888) 837-7347
Mailing address
431 E CLAIREMONT AVE, SUITE B, EAU CLAIRE, WI 54701-3685
(715) 514-3333
(888) 837-7347
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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