Donald E Larson Dmd PC

NPI #1417055062 in Eagle, Idaho

Provider Information

NPI Number: 1417055062
Entity Type: Organization
Organization Name: Donald E Larson Dmd PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 700 E STATE ST
Address 2: SUITE 100
City: Eagle
State: Idaho
ZIP Code: 83616
Phone: (208) 939-3500

Authorized Official

Name: DR. DONALD E LARSON, DMD
Title: PRESIDENT
Phone: (208) 939-1570

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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