Provider Demographics
NPI:1063640803
Name:E. GRANT LARKIN, D.D.S.. P.A.
Entity Type:Organization
Organization Name:E. GRANT LARKIN, D.D.S.. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:E.
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:LARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:620-275-4949
Mailing Address - Street 1:2510 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-3624
Mailing Address - Country:US
Mailing Address - Phone:620-275-4949
Mailing Address - Fax:620-275-0149
Practice Address - Street 1:2510 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-3624
Practice Address - Country:US
Practice Address - Phone:620-275-4949
Practice Address - Fax:620-275-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty