Bryce Robert Larsen, D.M.D.

NPI #1821210535 in Pocatello, Idaho

Provider Information

NPI Number
1821210535
Entity Type
Individual
Name
Bryce Robert Larsen, D.M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist - General Practice
Credential
D.M.D.
Enumeration Date
May 3, 2007
Last Updated
Jul 8, 2007

Practice Location

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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