Provider Demographics
NPI:1346221835
Name:LARKIN, JOHN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:LARKIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IL
Mailing Address - Zip Code:61727-1640
Mailing Address - Country:US
Mailing Address - Phone:217-935-5216
Mailing Address - Fax:
Practice Address - Street 1:323 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727-1640
Practice Address - Country:US
Practice Address - Phone:217-935-5216
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice