Larson, Daniel Allen
Larson, Daniel Allen is an sole proprietor health care provider with primary practice located at 317 E Kimberly Ave , Kimberly WI 54136-1406. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Larson, Daniel Allen can be contacted via phone (920) 788-2871.Contact Information
Primary practice address
317 E Kimberly Ave
Kimberly WI 54136-1406
Phone: (920) 788-2871
Fax: (192) 078-8287
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5001350 | Wisconsin |
Profile Details
| NPI number | 1750430088 |
|---|---|
| LBN Legal business name | Larson, Daniel Allen |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750430088 | NPPES |
| Wisconsin | Other | 5001350 | STATE DENTAL LICENSE |
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