Kent Large, DMD Valid NPI

Individual provider · Dentist · Goldendale, WA

NPI

1285154435

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

DE60748917 (WA)

Sex

Male

Sole proprietor

No

Enumerated

2017-06-20

Last updated

2019-10-30