| Doctor Name: | MS. LAURA LEE LARSON |
| NPI Number: | 1154509677 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D.H. |
| License Number: | 16999 |
| Business Practice Address: | 27201 Highway 189 Blue Jay, CA - 92317 |
| Business Phone Number: | 9093376670 |
| Business Fax Number: | |
| Mailing Address: | Po Box 898, RUNNING SPRINGS |
| State: | CA |
| Postal Code: | 923820898 |
| Phone Number: | 9098671145 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2008 |
| NPI Last Update Date: | 02/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 126900000X |
| License Number: | 16999 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dental Laboratory Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary. |