Provider Demographics
NPI:1457400996
Name:LARKINS, TERESA K (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:K
Last Name:LARKINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087
Mailing Address - Country:US
Mailing Address - Phone:615-444-3932
Mailing Address - Fax:615-444-5831
Practice Address - Street 1:1030 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087
Practice Address - Country:US
Practice Address - Phone:615-444-3932
Practice Address - Fax:615-444-5831
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN71231223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice