Provider Demographics
NPI:1598814196
Name:LARRY L SHAPIRO DDS PA
Entity Type:Organization
Organization Name:LARRY L SHAPIRO DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-753-0520
Mailing Address - Street 1:1500 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8914
Mailing Address - Country:US
Mailing Address - Phone:954-753-0520
Mailing Address - Fax:954-753-0550
Practice Address - Street 1:1500 N UNIVERSITY DR
Practice Address - Street 2:SUITE 111
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8914
Practice Address - Country:US
Practice Address - Phone:954-753-0520
Practice Address - Fax:954-753-0550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6993261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental