| Donald E Larson Dmd Pc | |
|
700 E State St Suite 100 Eagle ID 83616 | |
| (208) 939-3500 | |
| (208) 939-3837 |
| Full Name | Donald E Larson Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 700 E State St, Eagle, Idaho |
| Authorized Official Name and Position | Donald E Larson (PRESIDENT) |
| Authorized Official Contact | 2089391570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald E Larson Dmd Pc 5919 N Lilybrook Pl Boise ID 83713 Ph: (208) 939-1570 | Donald E Larson Dmd Pc 700 E State St Suite 100 Eagle ID 83616 Ph: (208) 939-3500 |
| NPI Number | 1417055062 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417055062 | NPI | - | NPPES |
| 8061442 | Medicaid | ID | |
| CS9245 | Other | ID | ID STATE BOARD OF PHARM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3551 (Idaho) | Primary |
Lighthouse Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1177 N Eagle Rd, Eagle, ID 83616 Phone: 208-939-3010 Fax: 208-939-3027 | |
Eagle Dental Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 577 E State St, Eagle, ID 83616 Phone: 208-342-4644 | |
Premier Dentistry Of Eagle Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 467 S Rivershore Ln, Eagle, ID 83616 Phone: 208-938-1247 | |
Eagle Oral Surgery And Dental Implant Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 197 W State St, Eagle, ID 83616 Phone: 208-995-2865 | |
Hathaway And Pelletier Family Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1217 E Iron Eagle Dr, Eagle, ID 83616 Phone: 208-377-1161 Fax: 208-938-0567 | |
Evan Hathaway Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1217 E Iron Eagle Dr, Eagle, ID 83616 Phone: 208-377-1161 Fax: 208-938-0567 |