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Individual

DR. BRENT A. LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
928 E 100 S, STE #A, SALT LAKE CITY, UT 84102-1455
(801) 355-5558
(801) 322-0629
Mailing address
928 E 100 S, STE #A, SALT LAKE CITY, UT 84102-1455
(801) 355-5558
(801) 322-0629

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
139116-9922
UT

Other

Enumeration date
03/14/2007
Last updated
10/22/2023
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