Keith R Larson Dmd PC

NPI #1093185118 in Beaverton, Oregon

Provider Information

NPI Number: 1093185118
Entity Type: Organization
Organization Name: Keith R Larson Dmd PC
Primary Specialty: Durable Medical Equipment & Medical Supplies - Customized Equipment
Enumeration Date: Oct 1, 2015
Last Updated: Oct 20, 2017

Practice Location

Address: 17895 NW EVERGREEN PKWY
Address 2: 130
City: Beaverton
State: Oregon
ZIP Code: 97006-7402
Phone: (503) 716-6712

Authorized Official

Name: DR. KEITH RODNEY LARSON, DMD, PC
Title: OWNER
Phone: (503) 292-0416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X	Primary

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