Individual
DR. CYRUS MICHAEL LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
628 SOUTH AVE W, SUITE B, MISSOULA, MT 59801-8020
(801) 310-7039
Mailing address
628 SOUTH AVE W, SUITE B, MISSOULA, MT 59801-8020
(801) 310-7039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9630
MT
Other
Enumeration date
11/04/2010
Last updated
11/10/2016
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