Provider Demographics
NPI:1659496859
Name:LARRY K SOWDER DDS PC
Entity Type:Organization
Organization Name:LARRY K SOWDER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:SOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:865-689-2175
Mailing Address - Street 1:2944 TAZEWELL PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918
Mailing Address - Country:US
Mailing Address - Phone:865-689-2175
Mailing Address - Fax:865-689-5150
Practice Address - Street 1:2944 TAZEWELL PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918
Practice Address - Country:US
Practice Address - Phone:865-689-2175
Practice Address - Fax:865-689-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3124122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty