Individual
DR. JON PHILIP LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
497 CINCINNATI BATAVIA PIKE, CINCINNATI, OH 45244-4212
(513) 528-1223
(513) 328-6123
Mailing address
497 CINCINNATI BATAVIA PIKE, CINCINNATI, OH 45244-4212
(513) 528-1223
(513) 328-6123
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-01-3524
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0211765
—
OH
Enumeration date
08/04/2005
Last updated
07/08/2007
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