KEITH R LARSON DMD, PC
Suppliers at Evergreen Pkwy, Beaverton, OR

License number
Oregon D4338
Category
Suppliers
Type
Customized Equipment
Owner
Name: DR. KEITH RODNEY LARSON DMD, PC
Title: OWNER
Phone: (503) 292-0416
Address
Address
17895 NW Evergreen Pkwy, Beaverton, OR 97006
National Provider ID: 1093185118
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KEITH R LARSON, DMD, PC

17895 NW Evergreen Pkwy STE 130, Beaverton, OR 97006

Industry:
Dentist's Office
Doing business as:
Keith R Larson DMD
Registration:
Jan 26, 1998
Phone:
(503) 533-9868 (Phone)
State ID:
61475084
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Owner, Family And General Dentistry, General Dentist:
Keith Larson (Owner, Family And General Dentistry, General Dentist)
Agent:
Jon Rsummers,851 SW 6 Ave STE 1500, Portland, OR 97204 (Physical)

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