Provider Demographics
NPI:1174652747
Name:FINK, LARRY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:JOSEPH
Last Name:FINK
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 1:18425 N 51ST AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1488
Mailing Address - Country:US
Mailing Address - Phone:602-942-4260
Mailing Address - Fax:
Practice Address - Street 1:18425 N 51ST AVE STE C
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1488
Practice Address - Country:US
Practice Address - Phone:602-942-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice