| Thomas H Larson DDS Inc | |
|
7780 N Fresno St Suite 105 Fresno CA 93720-2413 | |
| (559) 431-9701 | |
| (559) 431-9121 |
| Full Name | Thomas H Larson DDS Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7780 N Fresno St, Fresno, California |
| Authorized Official Name and Position | Thomas Hartman Larson (PEDIATRIC DENTIST, OWNER) |
| Authorized Official Contact | 5594319701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas H Larson DDS Inc 7780 N Fresno St Suite 105 Fresno CA 93720-2413 Ph: (559) 431-9701 | Thomas H Larson DDS Inc 7780 N Fresno St Suite 105 Fresno CA 93720-2413 Ph: (559) 431-9701 |
| NPI Number | 1578704169 |
|---|---|
| Provider Enumeration Date | 03/12/2009 |
| Last Update Date | 03/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578704169 | NPI | - | NPPES |
| B25928-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 25928 (California) | Primary |
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