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General NPI Number Information
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NPI Number | 1659496859
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Entity Type | Organization
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Legal Business Name | LARRY K SOWDER DDS PC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2944 TAZEWELL PIKE SUITE 2
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City | KNOXVILLE
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State | TN
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Zip | 37918
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Country | US
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Telephone | 865-689-2175
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Fax | 865-689-5150
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Provider Business Mailing Address
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Address Line | 2944 TAZEWELL PIKE SUITE 2
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City | KNOXVILLE
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State | TN
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Zip | 37918
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Country | US
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Telephone | 865-689-2175
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Fax | 865-689-5150
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LARRY KYLE SOWDER
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Credential | DDS
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Telephone | 865-689-2175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS3124
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License Number State | TN
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