Niels Willard Larsen V, D.D.S.

NPI #1770796070 in Pocatello, Idaho

Provider Information

NPI Number: 1770796070
Entity Type: Individual
Name: Niels Willard Larsen V, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: May 7, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 950 HOSPITAL WAY
Address 2: SUITE B
City: Pocatello
State: Idaho
ZIP Code: 83201-2789
Phone: (208) 233-7007

Specialties & Taxonomy Codes

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

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