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General NPI Number Information
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NPI Number | 1699822452
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Entity Type | Individual
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Provider Name | LARRY JOHN SANGRIK DDS
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 SOUTH ST STE 3B-1
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City | CHARDON
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State | OH
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Zip | 44024-2818
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Country | US
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Telephone | 440-286-7138
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Fax | 440-286-7139
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Provider Business Mailing Address
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Address Line | 401 SOUTH ST STE 3B-1
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City | CHARDON
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State | OH
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Zip | 44024-2818
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Country | US
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Telephone | 440-286-7138
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Fax | 440-286-7139
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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 | 30-016246
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License Number State | OH
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