| Lake Havasu Orthodontics Llc | |
|
2061 Smoketree Ave N Lake Havasu City AZ 86403-5811 | |
| (928) 854-4141 | |
| Not Available |
| Full Name | Lake Havasu Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2061 Smoketree Ave N, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Ethan Larson (DOCTOR/OWNER) |
| Authorized Official Contact | 2532832747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Havasu Orthodontics Llc 2212 E Aris Dr Gilbert AZ 85298-1205 Ph: (253) 283-2747 | Lake Havasu Orthodontics Llc 2061 Smoketree Ave N Lake Havasu City AZ 86403-5811 Ph: (928) 854-4141 |
| NPI Number | 1225759111 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225759111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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