Affordable Dentures- Peoria, P.c

NPI #1477824977 in Peoria, Illinois

Provider Information

NPI Number: 1477824977
Entity Type: Organization
Organization Name: Affordable Dentures- Peoria, P.c
Primary Specialty: Dentist
Enumeration Date: Jan 16, 2012
Last Updated: Jan 16, 2012

Practice Location

Address: 2807 W TOWNLINE RD
City: Peoria
State: Illinois
ZIP Code: 61615-1557
Phone: (309) 689-1452

Authorized Official

Name: DR. PAUL D. LARSEN, DDS
Title: PRACTICE OWNER
Phone: (309) 689-1452

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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