Organization
PAUL C LARSEN DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL LARSEN DMD (OWNER)
(801) 295-8881
Entity
Organization
Contact information
Practice address
415 MEDICAL DR, STE D201, BOUNTIFUL, UT 84010-4946
(801) 295-8881
(801) 203-2947
Mailing address
415 MEDICAL DR, STE D201, BOUNTIFUL, UT 84010-4946
(801) 295-8881
(801) 203-2947
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5332372-9922
UT
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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