Alisha Marie Larson RDH BS

NPI 1780842526 - Dental Hygienist - 124Q00000X

NPI Details
NPI 1780842526
Gender Female
Enumeration Date 05/29/2008
Last Updated 05/29/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
29 BLACK COAL DRIVE
FORT WASHAKIE WY, 82514, US
Phone (307) 332-3527
Fax
Business Location
1210 MCDOUGALL DR
LANDER WY, 82520-3531, US
Phone (307) 335-5960
Fax
Toxanomy
Taxonomy Code 124Q00000X
License State Wyoming
License Number 747
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According to our database, Mrs. Alisha Marie Larson RDH BS NPI is 1780842526, taxonomy code is 124Q00000X and license number is 747, license state is located at Wyoming. Alisha Marie Larson RDH BS physically located at 29 Black Coal Drive, Fort Washakie WY, 82514. NPI Number Alisha Marie Larson RDH BS has the Individual type.

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1780842526 NPI number is provided on an as is basis without warranty of any kind. 1780842526 is maintained by the National Plan & Provider Enumeration System. The contents of Alisha Marie Larson RDH BS are for informational purposes only.