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General NPI Number Information
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NPI Number | 1033288493
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Entity Type | Individual
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Provider Name | LARRY BARGREN DDS
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1830 S ALMA SCHOOL RD STE 110
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City | MESA
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State | AZ
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Zip | 85210-3086
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Country | US
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Telephone | 480-834-1317
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Fax | 480-649-6148
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Provider Business Mailing Address
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Address Line | 6191 E FLAT IRON LOOP
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City | APACHE JUNCTION
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State | AZ
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Zip | 85218-1877
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Country | US
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Telephone | 480-474-8052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D6421
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License Number State | AZ
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