Larry Mike Bloodsworth DDS

NPI 1013025121 - Dentist - 122300000X

NPI Details
NPI 1013025121
Gender Male
Enumeration Date 08/28/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1001 MAGNOLIA DRIVE
TYLER TX, 75701, US
Phone (903) 595-2707
Fax
Business Location
1001 MAGNOLIA DRIVE
TYLER TX, 75701, US
Phone (903) 595-2707
Fax
Toxanomy
Taxonomy Code 122300000X
License State Texas
License Number 11305
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According to our database, Dr. Larry Mike Bloodsworth DDS NPI is 1013025121, taxonomy code is 122300000X and license number is 11305, license state is located at Texas. Larry Mike Bloodsworth DDS physically located at 1001 Magnolia Drive, Tyler TX, 75701. NPI Number Larry Mike Bloodsworth DDS has the Individual type.

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1013025121 NPI number is provided on an as is basis without warranty of any kind. 1013025121 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Mike Bloodsworth DDS are for informational purposes only.