Larson, Jeremy

Larson, Jeremy is an individual health care provider with primary practice located at 300 Tatone , Boardman OR 97818. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Larson, Jeremy can be contacted via phone (888) 468-0022.

Contact Information

Primary practice address
300 Tatone Boardman OR 97818
Phone: (888) 468-0022
Fax: (541) 504-3907
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D9625 Oregon

Profile Details

NPI number 1770861791
LBN Legal business name Larson, Jeremy
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2011
Last updated Jan 27th, 2015 - about 9 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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