Healthcare Provider Details

I. General information

NPI: 1083957138
Provider Name (Legal Business Name): ALAN LARKIN DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10645 DOUBLE R BLVD
RENO NV
89521-8920
US

IV. Provider business mailing address

10645 DOUBLE R BLVD
RENO NV
89521-8920
US

V. Phone/Fax

Practice location:
  • Phone: 775-852-6164
  • Fax:
Mailing address:
  • Phone: 775-852-6164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3-244
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: