W.brent Larsen, D.d.s., P.a.

NPI 1053591495 - Clinic/Center - 261QD0000X

NPI Details
NPI 1053591495
Enumeration Date 11/13/2007
Last Updated 11/13/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name W. BRENT W. BRENT
Position OWNER
Phone (501) 843-9306
Fax (501) 843-4251
Practice Location
3 TEMPLETON DR
CABOT AR, 72023-3821, US
Phone (501) 843-9306
Fax (501) 843-4251
Business Location
3 TEMPLETON DR
CABOT AR, 72023-3821, US
Phone (501) 843-9306
Fax (501) 843-4251
Toxanomy
Taxonomy Code 261QD0000X
License State Arkansas
License Number 2976
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According to our database, W.brent Larsen, D.d.s., P.a. NPI is 1053591495, taxonomy code is 261QD0000X and license number is 2976, license state is located at Arkansas. W.brent Larsen, D.d.s., P.a. physically located at 3 Templeton Dr, Cabot AR, 72023-3821. NPI Number 1033115704 has the healthcare provider type.

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1053591495 NPI number is provided on an as is basis without warranty of any kind. 1053591495 is maintained by the National Plan & Provider Enumeration System. The contents of W.brent Larsen, D.d.s., P.a. are for informational purposes only.