Larsen Family Dental S.c.

NPI #1245280742 in Beaver Dam, Wisconsin

Provider Information

NPI Number: 1245280742
Entity Type: Organization
Organization Name: Larsen Family Dental S.c.
Primary Specialty: Dentist
Enumeration Date: May 12, 2006
Last Updated: Aug 23, 2013

Practice Location

Address: 215 N. SPRING STREET
City: Beaver Dam
State: Wisconsin
ZIP Code: 53916
Phone: (920) 885-6066

Authorized Official

Name: MRS. ANDREA K LARSEN, DDS
Title: OWNER
Phone: (920) 885-6066

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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