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General NPI Number Information
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NPI Number | 1497938468
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Entity Type | Individual
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Provider Name | MATTHEW C. LARGENT D.D.S., M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2832 E MARTIN LUTHER KING JR. BLVD SUITE 102
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City | AUSTIN
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State | TX
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Zip | 78702-1504
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Country | US
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Telephone | 512-649-1180
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Fax | 512-649-4720
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Provider Business Mailing Address
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Address Line | 2832 E MARTIN LUTHER KING JR. BLVD SUITE 102
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City | AUSTIN
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State | TX
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Zip | 78702-1504
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Country | US
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Telephone | 512-649-1180
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Fax | 512-649-4720
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 21617
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License Number State | TX
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