MEDICARE: LARRY M. SCHECTER, D.M.D., PC

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	30016290	OH

General Provider Information

NPI Number	:	1184870511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARRY M. SCHECTER, D.M.D., PC

Provider Business Mailing Address
First Line	:	4903 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45217-1252
Country	:	US
Telephone Number	:	513-242-7747
Fax Number	:	513-242-1168

Provider Business Practice Location Address
First Line	:	4903 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45217-1252
Country	:	US
Telephone Number	:	513-242-7747
Fax Number	:	513-242-1168

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	NICOLE RENEE GOLLAR
Credential	:
Telephone Number	:	513-242-7747

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/18/2008

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