Larsen Dental Care | |
950 Hospital Way Suite B Pocatello ID 83201-2789 | |
(208) 233-7007 | |
Not Available |
Full Name | Larsen Dental Care |
---|---|
Speciality | Dentist - General Practice |
Location | 950 Hospital Way, Pocatello, Idaho |
Authorized Official Name and Position | Danielle Mabey (OFFICE MANAGER) |
Authorized Official Contact | 2082337007 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Larsen Dental Care 950 Hospital Way Suite B Pocatello ID 83201-2789 Ph: (208) 233-7007 | Larsen Dental Care 950 Hospital Way Suite B Pocatello ID 83201-2789 Ph: (208) 233-7007 |
NPI Number | 1285806844 |
---|---|
Provider Enumeration Date | 03/24/2008 |
Last Update Date | 03/24/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285806844 | NPI | - | NPPES |
8072105 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D1599 (Idaho) | Primary |
1223G0001X | Dentist - General Practice | D3894 (Idaho) | Secondary |
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