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General NPI Number Information
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NPI Number | 1316045834
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Entity Type | Organization
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Legal Business Name | LARRY E. MCENTIRE, D.D.S., P. C.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 1220 W ARIZONA AVE
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City | PARKER
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State | AZ
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Zip | 85344-5647
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Country | US
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Telephone | 928-669-2573
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Fax | 928-669-5953
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Provider Business Mailing Address
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Address Line | 8813 BUFFALO CLOUD AVE
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City | LAS VEGAS
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State | NV
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Zip | 89143-5407
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Country | US
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Telephone | 702-655-2882
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Fax | 702-655-7980
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY E. MCENTIRE
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Credential | D.D.S.
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Telephone | 928-669-2573
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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 |
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License Number State |
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