Provider Demographics
NPI:1285681601
Name:KINER, LARRY ERNEST (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:ERNEST
Last Name:KINER
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 1:2414A HERITAGE TRL
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1639
Mailing Address - Country:US
Mailing Address - Phone:580-242-0077
Mailing Address - Fax:580-242-0043
Practice Address - Street 1:2414A HERITAGE TRL
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1639
Practice Address - Country:US
Practice Address - Phone:580-242-0077
Practice Address - Fax:580-242-0043
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice