Provider Demographics
NPI:1437127586
Name:BANK, LARRY HERBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:HERBERT
Last Name:BANK
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 1:2116 W PRATT ST
Mailing Address - Street 2:
Mailing Address - City:BALTO
Mailing Address - State:MD
Mailing Address - Zip Code:21223
Mailing Address - Country:US
Mailing Address - Phone:410-233-3323
Mailing Address - Fax:410-233-1775
Practice Address - Street 1:2116 W PRATT ST
Practice Address - Street 2:
Practice Address - City:BALTO
Practice Address - State:MD
Practice Address - Zip Code:21223
Practice Address - Country:US
Practice Address - Phone:410-233-3323
Practice Address - Fax:410-233-1775
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4961122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist