Provider Demographics
NPI:1003928268
Name:LARKIN, WILLIAM A (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:LARKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E RIVER PARK LANE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706
Mailing Address - Country:US
Mailing Address - Phone:308-344-5024
Mailing Address - Fax:208-333-8911
Practice Address - Street 1:600 E RIVER PARK LANE
Practice Address - Street 2:SUITE 120
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706
Practice Address - Country:US
Practice Address - Phone:308-344-5024
Practice Address - Fax:208-333-8911
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD1837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist