Larsen Family Dental S.c. | |
215 N. Spring Street Beaver Dam WI 53916 | |
(920) 885-6066 | |
(920) 885-6192 |
Full Name | Larsen Family Dental S.c. |
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Speciality | Dentist |
Location | 215 N. Spring Street, Beaver Dam, Wisconsin |
Authorized Official Name and Position | Andrea K Larsen (OWNER) |
Authorized Official Contact | 9208856066 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Larsen Family Dental S.c. 215 N. Spring St. Beaver Dam WI 53916 Ph: (920) 885-6066 | Larsen Family Dental S.c. 215 N. Spring Street Beaver Dam WI 53916 Ph: (920) 885-6066 |
NPI Number | 1245280742 |
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Provider Enumeration Date | 05/12/2006 |
Last Update Date | 08/23/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245280742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 500159515 (Wisconsin) | Primary |
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