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General NPI Number Information
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NPI Number | 1154436129
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Entity Type | Individual
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Provider Name | LARRY GENE JAMES D.M.D
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 4100 S HOSPITAL DR SUITE 208
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City | PLANTATION
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State | FL
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Zip | 33317-2813
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Country | US
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Telephone | 954-791-6700
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Fax | 954-797-7622
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Provider Business Mailing Address
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Address Line | 4100 SOUTH HOSPITAL DRIVE SUITE 208
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City | PLANTATION
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State | FL
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Zip | 33317-0208
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Country | US
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Telephone | 954-791-6700
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Fax | 954-797-7622
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 9512
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License Number State | FL
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