Provider Demographics
NPI:1700339751
Name:DAVID LARCHER DDS
Entity Type:Organization
Organization Name:DAVID LARCHER DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BASIL
Authorized Official - Last Name:LARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-850-8075
Mailing Address - Street 1:24401 104TH AVE SE STE 101
Mailing Address - Street 2:
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:
Practice Address - Street 1:24401 104TH AVE SE STE 101
Practice Address - Street 2:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery