Provider Demographics
NPI:1720194467
Name:BARLOW, LARRY LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:LEE
Last Name:BARLOW
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:PO BOX 306
Mailing Address - Street 2:301 NORTH WARPATH DR
Mailing Address - City:MILAN
Mailing Address - State:IN
Mailing Address - Zip Code:47031
Mailing Address - Country:US
Mailing Address - Phone:812-654-2951
Mailing Address - Fax:812-654-3069
Practice Address - Street 1:301 NORTH WARPATH DR
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:IN
Practice Address - Zip Code:47031
Practice Address - Country:US
Practice Address - Phone:812-654-2951
Practice Address - Fax:812-654-3069
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist