Larson, Gregg Stuart

Larson, Gregg Stuart is an individual health care provider with primary practice located at 1900 Centracare Circle Ste 0350, St Cloud MN 56303-5000. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Larson, Gregg Stuart can be contacted via phone (320) 253-0272.

Contact Information

Primary practice address
1900 Centracare Circle Ste 0350 St Cloud MN 56303-5000
Phone: (320) 253-0272
Fax: (320) 251-2661
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 11344 Minnesota

Profile Details

NPI number 1780625772
LBN Legal business name Larson, Gregg Stuart
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Oct 2nd, 2014 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1780625772 NPPES
Minnesota MEDICAID 286909800
Minnesota Other 294L9LA
Minnesota Other HP37202

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