Provider Demographics
NPI:1033260773
Name:LARGURA, BURTON V (DDS)
Entity Type:Individual
Prefix:
First Name:BURTON
Middle Name:V
Last Name:LARGURA
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 1:13150 BROOKSHIRE PKWY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-4602
Mailing Address - Country:US
Mailing Address - Phone:317-385-9906
Mailing Address - Fax:
Practice Address - Street 1:2705 S BERKLEY RD STE 4A
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-8007
Practice Address - Country:US
Practice Address - Phone:765-453-2619
Practice Address - Fax:765-453-5076
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010166A1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics