Provider Demographics
NPI:1184870511
Name:LARRY M. SCHECTER, D.M.D., PC
Entity type:Organization
Organization Name:LARRY M. SCHECTER, D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-242-7747
Mailing Address - Street 1:4903 VINE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1252
Mailing Address - Country:US
Mailing Address - Phone:513-242-7747
Mailing Address - Fax:513-242-1168
Practice Address - Street 1:4903 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45217-1252
Practice Address - Country:US
Practice Address - Phone:513-242-7747
Practice Address - Fax:513-242-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30016290122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty