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NPI 1629362017

IndividualActive

Andrea Larsen, DDS

NPI 1629362017 · Dentist · Beaver Dam, WI

Provider details

NPI number: 1629362017
Entity type: Individual
Primary specialty: DentistDental Providers
Credential: DDS
Sex: Female
Sole proprietor: Yes
License: 6701-15 (WI)

Practice location

210 Madison St

Beaver Dam, WI 53916-2310

Phone: (920) 885-6066

More WI providers

Mailing address

210 Madison St

Beaver Dam, WI 53916-2310

Registry dates

Enumerated: 2011-06-03
Last updated: 2022-02-01

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Andrea Larsen, DDS — NPI 1629362017, Beaver Dam, WI | NPI Central