Hanson, Larissa W

Hanson, Larissa W is an individual health care provider with primary practice located at 3777 S Ridgewood Ave , Port Orange FL 32129-3528. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Hanson, Larissa W can be contacted via phone (386) 760-1200.

Contact Information

Primary practice address
3777 S Ridgewood Ave Port Orange FL 32129-3528
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN20640 Florida

Profile Details

NPI number 1013320142
LBN Legal business name Hanson, Larissa W
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2014
Last updated Jul 21st, 2014 - about 12 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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