Larson Family Dentistry | |
8086 E Florentine Rd Prescott Valley AZ 86314-9422 | |
(928) 772-8128 | |
(928) 772-2369 |
Full Name | Larson Family Dentistry |
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Speciality | Clinic/center - Dental |
Location | 8086 E Florentine Rd, Prescott Valley, Arizona |
Authorized Official Name and Position | Kelly J Larson (PARTNER) |
Authorized Official Contact | 9287728128 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Larson Family Dentistry 8086 E Florentine Rd Prescott Valley AZ 86314-9422 Ph: (928) 772-8128 | Larson Family Dentistry 8086 E Florentine Rd Prescott Valley AZ 86314-9422 Ph: (928) 772-8128 |
NPI Number | 1740655190 |
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Provider Enumeration Date | 12/10/2015 |
Last Update Date | 12/10/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740655190 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | D008229 (Arizona) | Secondary |
261QD0000X | Clinic/center - Dental | D04296 (Arizona) | Primary |
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