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Tyrel Larsen
Orthodontics and Dentofacial Orthopedic Dentist in Marion, Illinois
NPI 1396366381

Tyrel Larsen is a Orthodontics and Dentofacial Orthopedic Dentist based in Marion, IL and is specialized in Orthodontics and Dentofacial Orthopedics. Tyrel Larsen practices in Marion, IL. The NPI Number for Tyrel Larsen is 1396366381 and holds a License No. DS035312 (Illinois).

The current practice location address for Tyrel Larsen is 3108 W Deyoung St Ste A, Marion, IL and can be reached out via phone at 479-254-0669.

Location: 3108 W Deyoung St Ste A, Marion, IL, 62959-5548
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396366381
Provider Name
Tyrel Larsen
Credential
Provider Entity Type
Individual
Gender
Male
Address
3108 W Deyoung St Ste A, Marion, IL, 62959-5548
Phone Number
479-254-0669
Fax Number
Provider Enumeration Date
04/30/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3108 W Deyoung St Ste A
City
Marion
State
Illinois
Zip
62959-5548
Phone Number
479-254-0669
Fax Number
person
Provider Business Mailing Address Details
Address
3108 W Deyoung St Ste A
City
Marion
State
Illinois
Zip
62959-5548
Phone Number
479-254-0669
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Orthodontics and Dentofacial Orthopedics
Taxonomy
1223X0400X
License No.
021.003269 (Illinois)
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
DS035312 (Pennsylvania)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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