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General NPI Number Information
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NPI Number | 1891784039
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Entity Type | Individual
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Provider Name | LARRY G LYLES DDS
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 7603 GEORGIA AVE NW SUITE 403
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City | WASHINGTON
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State | DC
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Zip | 20012-1617
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Country | US
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Telephone | 202-723-8284
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Fax | 301-990-1449
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Provider Business Mailing Address
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Address Line | 10506 FORESTGATE PL
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City | GLENN DALE
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State | MD
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Zip | 20769-2038
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Country | US
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Telephone | 301-809-0919
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Fax | 301-805-9696
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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 |
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License Number State | DC
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