National Provider Identifier
Douglas Marshall Larson, D.D.S.
Douglas Marshall Larson, D.D.S. is listed in the NPPES registry with a primary specialty of Orthodontics and Dentofacial Orthopedics Dentistry in Jamestown, NY and a listed phone number of (716) 483-1718.
Profile Overview
- NPI
- 1366432098
- Provider Type
- Individual
- Primary Specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Enumeration Date
- October 25, 2005
- Last Updated
- May 12, 2014
Practice Location
- 680 Fairmount Ave
- Jamestown, NY 14701-2630
Phone: (716) 483-1718
Specialties
- Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
- Dentist (122300000X)
Full Record
- NPI
- 1366432098
- Entity Type
- Individual
- Last Name
- Larson
- First Name
- Douglas
- Middle Name
- Marshall
- Name Prefix
- Dr.
- Credential
- D.D.S.
- Mailing Street Address
- 680 Fairmount Ave
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-2630
- Mailing Country
- US
- Mailing Phone
- (716) 483-1718
- Mailing Fax
- (716) 661-9623
- Practice Street Address
- 680 Fairmount Ave
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-2630
- Practice Country
- US
- Practice Phone
- (716) 483-1718
- Practice Fax
- (716) 661-9623
- Enumeration Date
- October 25, 2005
- Last Updated
- May 12, 2014
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), Dentist (122300000X)
- Other Identifiers
- 02740834 (NY)