Larsen, Ivan M

Larsen, Ivan M is an individual health care provider with primary practice located at 1002 Diamond Rdg Ste 1500 , Jefferson City MO 65109-7914. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Larsen, Ivan M can be contacted via phone (573) 298-4400.

Contact Information

Primary practice address
1002 Diamond Rdg Ste 1500 Jefferson City MO 65109-7914
Phone: (573) 298-4400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D-4797 Idaho
Dental Providers / Dentist 122300000X 2019008323 Missouri
Dental Providers / Endodontics 1223E0200X 2019008323 Missouri

Profile Details

NPI number 1285185355
LBN Legal business name Larsen, Ivan M
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2016
Last updated Sep 28th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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