Provider Demographics
NPI:1396054748
Name:LARSEN AND EHLERS
Entity type:Organization
Organization Name:LARSEN AND EHLERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATRNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:L
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-338-3577
Mailing Address - Street 1:3520 S SHELDON LN
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6121
Mailing Address - Country:US
Mailing Address - Phone:605-338-3577
Mailing Address - Fax:605-338-5082
Practice Address - Street 1:3520 S SHELDON LN
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6121
Practice Address - Country:US
Practice Address - Phone:605-338-3577
Practice Address - Fax:605-338-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty