Provider Demographics
NPI:1760563290
Name:FINCHER, LARRY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:R
Last Name:FINCHER
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 10900
Mailing Address - Street 2:4206 PRINCE ST.
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-0016
Mailing Address - Country:US
Mailing Address - Phone:501-336-8478
Mailing Address - Fax:501-336-8478
Practice Address - Street 1:4206 HWY. 60
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-0016
Practice Address - Country:US
Practice Address - Phone:501-336-8478
Practice Address - Fax:501-336-8478
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA846613OtherUNITED CONCORDIA
AR58712OtherBLUE CROSS BLUE SHIELD