Jeffrey D Larson, D.M.D., P.C.

NPI #1164435855 in Caldwell, Idaho

Provider Information

NPI Number
1164435855
Entity Type
Individual
Name
Jeffrey D Larson, D.M.D., P.C.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
D.M.D., P.C.
Enumeration Date
Aug 14, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
1211 S KIMBALL AVE
State
Idaho
ZIP Code
83605-4626
Phone
(208) 454-2061

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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