Provider Demographics
NPI:1912045857
Name:LARCHER, DAVID BASIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BASIL
Last Name:LARCHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:24401 104TH AVE SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-4903
Mailing Address - Country:US
Mailing Address - Phone:253-850-8075
Mailing Address - Fax:253-854-9673
Practice Address - Street 1:24401 104TH AVE SE
Practice Address - Street 2:SUITE 101
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-4903
Practice Address - Country:US
Practice Address - Phone:253-850-8075
Practice Address - Fax:253-854-9673
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA69981223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery