Provider Demographics
NPI:1730122144
Name:PACE, LARRY LEON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:LEON
Last Name:PACE
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:4231 SIGMA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4423
Mailing Address - Country:US
Mailing Address - Phone:972-233-5447
Mailing Address - Fax:972-702-8887
Practice Address - Street 1:4231 SIGMA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4423
Practice Address - Country:US
Practice Address - Phone:972-233-5447
Practice Address - Fax:972-702-8887
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX108831223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics