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General NPI Number Information
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NPI Number | 1063640803
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Entity Type | Organization
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Legal Business Name | E. GRANT LARKIN, D.D.S.. P.A.
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 2510 HENDERSON DR
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City | GARDEN CITY
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State | KS
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Zip | 67846-3624
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Country | US
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Telephone | 620-275-4949
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Fax | 620-275-0149
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Provider Business Mailing Address
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Address Line | 2510 HENDERSON DR
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City | GARDEN CITY
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State | KS
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Zip | 67846-3624
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Country | US
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Telephone | 620-275-4949
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Fax | 620-275-0149
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Authorized Official
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Title or Position | OWNER PRACTITIONER
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Name | DR. E. GRANT LARKIN
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Credential | D.D.S.
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Telephone | 620-275-4949
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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 |
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License Number State |
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