MEDICARE: DR. MATTHEW BRENT LARSON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	7362558-9922	UT
2	1223G0001X	General Practice Dentistry	7362558-9922	UT

General Provider Information

NPI Number	:	1902034119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW BRENT LARSON D.D.S.

Provider Business Mailing Address
First Line	:	928 E 100 S
Second Line	:	SUITE A
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1455
Country	:	US
Telephone Number	:	801-860-5010
Fax Number	:

Provider Business Practice Location Address
First Line	:	928 E 100 S
Second Line	:	SUITE A
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1455
Country	:	US
Telephone Number	:	801-860-5010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	04/21/2010

Similar Medicare Providers

1891829941 — DR. BRENT A. LARSON D.D.S.
Practice Location Address:

928 E 100 S , STE #A
SALT LAKE CITY, UT
84102-1455

Practice Phone: 801-355-5558
Practice Fax: 801-322-0629

1417081308 — DR. ERIC A. LARSON D.D.S.
Practice Location Address:

928 E 100 S , STE #B
SALT LAKE CITY, UT
84102-1455

Practice Phone: 801-355-4733
Practice Fax: 801-322-0629

1346446150 — DR. SCOTT ANDREW LARSON D.M.D.
Practice Location Address:

928 E 100 S
SALT LAKE CITY, UT
84102-1455

Practice Phone: 801-355-3322
Practice Fax: 801-322-0629

1083958433 — DR. CASEY WOOD CLIFFORD D.D.S.
Practice Location Address:

928 E 100 S , SUITE E
SALT LAKE CITY, UT
84102-1455

Practice Phone: 801-355-5657
Practice Fax:

1871518407 — SMITHS FOOD & DRUG CENTERS INC
Practice Location Address:

828 S 900 W
SALT LAKE CITY, UT
84104-1455

Practice Phone: 801-364-2564
Practice Fax: 801-363-4633

1841510096 — MELISSA FOWLER PHARM.D.
Practice Location Address:

828 S 900 W
SALT LAKE CITY, UT
84104-1455

Practice Phone: 801-364-2564
Practice Fax:

Directions to “ DR. MATTHEW BRENT LARSON D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.