MRS. Alisha Marie Larson, RDH BS

NPI #1780842526 in Fort Washakie, Wyoming

Provider Information

NPI Number: 1780842526
Entity Type: Individual
Name: MRS. Alisha Marie Larson, RDH BS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH BS
Enumeration Date: May 29, 2008
Last Updated: May 29, 2008

Practice Location

Address: 29 BLACK COAL DRIVE
City: Fort Washakie
State: Wyoming
ZIP Code: 82514
Phone: (307) 332-3527

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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