Provider Demographics
NPI:1942513957
Name:LARSON, CHRISTI ANN (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:ANN
Last Name:LARSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:ANN
Other - Last Name:DREXLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813-1457
Mailing Address - Country:US
Mailing Address - Phone:608-723-2141
Mailing Address - Fax:
Practice Address - Street 1:237 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-1457
Practice Address - Country:US
Practice Address - Phone:608-723-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087491223G0001X
WI6567-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice