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
Phone: (386) 760-1200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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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