Dr. Ruby C Carlson Larson, DDS
Dentist in Kelseyville, CA. Individual provider (NPI-1).
NPI number1043435530
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1043435530
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ruby C Carlson Larson
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 39606 | CA | Yes |
Practice location
9750 State Hwy 281Ste J
Kelseyville, CA 95451-9636
Phone 707-277-9100
Mailing address
9750 State Hwy 281Ste J
Kelseyville, CA 95451-9636
Phone 707-277-9100
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