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Organization

LARSON DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CORY J LARSON DDS (OWNER)
(612) 789-2853
Entity
Organization

Contact information

Practice address
1632 WASHINGTON ST NE, MINNEAPOLIS, MN 55413-1336
(612) 789-2853
Mailing address
1632 WASHINGTON ST NE, MINNEAPOLIS, MN 55413-1336
(612) 789-2853

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
08/22/2022
Last updated
08/22/2022
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