Wadena Family Dental, P. A.

NPI #1881864049 in Wadena, Minnesota

Provider Information

NPI Number: 1881864049
Entity Type: Organization
Organization Name: Wadena Family Dental, P. A.
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 4, 2008
Last Updated: Mar 4, 2008

Practice Location

Address: 122 COLFAX AVE SW
City: Wadena
State: Minnesota
ZIP Code: 56482-1470
Phone: (218) 631-4525

Authorized Official

Name: DR. WILLIAM KIM LARSON, DDS
Title: DENTIST
Phone: (218) 631-4525

Specialties & Taxonomy Codes

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

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Organizations

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