Larson, Donald E
Larson, Donald E is an sole proprietor health care provider with primary practice located at 700 E State St Ste 100 , Eagle ID 83616-5941. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Larson, Donald E can be contacted via phone (208) 939-3500.Contact Information
Primary practice address
700 E State St Ste 100
Eagle ID 83616-5941
Phone: (208) 939-3500
Fax: (208) 939-9897
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D3551 | Idaho |
Profile Details
| NPI number | 1235435744 |
|---|---|
| LBN Legal business name | Larson, Donald E |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2011 |
| Last updated | Jan 31st, 2011 - about 15 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 | 1235435744 | NPPES |
| Idaho | MEDICAID | 8061442 | |
| Idaho | Other | CS9245 | |
| Idaho | Other | 1312746 |
Popular Providers
-
Charles, Colton
450 W State St Ste 180 , Eagle ID 83616-6974 -
Stott, Caleb Edward
467 S. Rivershore Lane , Eagle ID 83616-4978 -
Jensen, Brian Clark
1177 N Eagle Rd , Eagle ID 83616-5017 -
Dolby, Michael G
90 Cottonwood Ct Ste 100 , Eagle ID 83616-6577 -
Baird, Andrew Dale
483 S Rivershore Ln Ste 102 , Eagle ID 83616-4978 -
Seyler, Michael John
45 W Cottonwood Ct Suite 110, Eagle ID 83616 -
Chen, George D.
1564 E Crowne Point Dr , Eagle ID 83616 -
Van Alfen, Ryan N
483 S Rivershore Ln Ste 102 , Eagle ID 83616-4978