Provider Demographics
NPI:1831253608
Name:TULEY, LARRY STEVE (DDS)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:STEVE
Last Name:TULEY
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 1:2520 N ALDER ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-6632
Mailing Address - Country:US
Mailing Address - Phone:253-572-6670
Mailing Address - Fax:253-572-9982
Practice Address - Street 1:2520 N ALDER ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-6632
Practice Address - Country:US
Practice Address - Phone:253-572-6670
Practice Address - Fax:253-572-9982
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000040421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice