Russell M Larsen is a Dentist in Montesano, Washington. Russell M Larsen practices all healthcare services and medical treatments related to Dentist. The NPI Number for Russell M Larsen is 1013014471. The last update date is 2007-07-09.
Russell M Larsen's current location address is 208 E Broadway Ave, Montesano, Washington. You can contact this provider via phone number 3602493151 and fax number 3602495129. The mailing address for Russell M Larsen is 208 E Broadway Ave, Montesano, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Russell M Larsen |
|---|---|
| Address | 208 E Broadway Ave, Montesano, Washington |
| Phone Number | 3602493151 |
| Fax Number | 3602495129 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1013014471 |
|---|---|
| Provider Enumeration Date | 2006-09-20 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 208 E Broadway Ave |
|---|---|
| City | Montesano |
| State | Washington (WA) |
| Post Code | 985633706 |
| Phone Number | 3602493151 |
| Fax Number | 3602495129 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | DE00007407 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5032016 | WA | -- |
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What is the unique 10-digit identifier code issued to Russell M Larsen by the Centers for Medicare & Medicaid Services?
The Russell M Larsen has been assigned the NPI (National Provider Identifier) 1013014471 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Russell M Larsen?
The Russell M Larsen is situated at 208 E Broadway Ave, in the city of Montesano, state of WA, with the zip code 985633706.
What is Russell M Larsen's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Russell M Larsen is Dentist, and the taxonomy code that categorizes this field of expertise is 122300000X.
When was the Russell M Larsen's 1013014471 issued?
The Russell M Larsen's 1013014471 was issued on 2006-09-20.
When was the information regarding Russell M Larsen most recently updated?
The details pertaining to the Russell M Larsen, including its address, specialty, and other relevant information, were last refreshed on 2007-07-09.