Provider Demographics
NPI:1295986396
Name:LARSEN, RYAN KENT (DMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:KENT
Last Name:LARSEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 GRAND AVE #198
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0001
Mailing Address - Country:US
Mailing Address - Phone:406-855-0844
Mailing Address - Fax:406-969-6659
Practice Address - Street 1:3031 GRAND AVE #198
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-0001
Practice Address - Country:US
Practice Address - Phone:406-855-0844
Practice Address - Fax:406-206-6925
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-76871223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology