Provider Demographics
NPI:1740224864
Name:LEVIN, LARRY I (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:I
Last Name:LEVIN
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 1:1531 OCEAN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-3534
Mailing Address - Country:US
Mailing Address - Phone:781-834-9222
Mailing Address - Fax:781-834-9817
Practice Address - Street 1:1531 OCEAN ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-3534
Practice Address - Country:US
Practice Address - Phone:781-834-9222
Practice Address - Fax:781-834-9817
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice