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General NPI Number Information
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NPI Number | 1104939776
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Entity Type | Organization
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Legal Business Name | LARRY G. CAUSEY, DDS., PA.
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 204 S MARSHALL ST
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City | GRAHAM
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State | NC
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Zip | 27253-3322
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Country | US
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Telephone | 336-227-1187
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Fax | 336-506-1004
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Provider Business Mailing Address
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Address Line | 204 S. MARSHALL STREET P.O. BOX 764
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City | GRAHAM
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State | NC
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Zip | 27253-3322
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Country | US
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Telephone | 336-227-1187
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Fax | 336-506-1004
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY GRADY CAUSEY
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Credential | D.D.S.
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Telephone | 336-227-1187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0993
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License Number State | NC
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