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NPI 1457400996

NPI 1457400996 : TERESA K. LARKINS DMD : LEBANON, TN

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General NPI Number Information
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    NPI Number           |    1457400996
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    Entity Type          |    Individual 
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    Provider Name        |    TERESA K. LARKINS DMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/10/2007
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    Last Update Date     |    10/30/2014
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Provider Practice Location Address
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    Address Line         |    1030 WEST MAIN STREET 
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    City                 |    LEBANON
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    State                |    TN
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    Zip                  |    37087
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    Country              |    US
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    Telephone            |    615-444-3932
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    Fax                  |    615-444-5831
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Provider Business Mailing Address
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    Address Line         |    1030 WEST MAIN STREET 
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    City                 |    LEBANON
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    State                |    TN
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    Zip                  |    37087
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    Country              |    US
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    Telephone            |    615-444-3932
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    Fax                  |    615-444-5831
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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       |    7123
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    7123
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    License Number State |    TN
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