Provider Demographics
NPI:1154436129
Name:JAMES, LARRY GENE (DMD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:GENE
Last Name:JAMES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SOUTH HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-0208
Mailing Address - Country:US
Mailing Address - Phone:954-791-6700
Mailing Address - Fax:954-797-7622
Practice Address - Street 1:4100 S HOSPITAL DR
Practice Address - Street 2:SUITE 208
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2813
Practice Address - Country:US
Practice Address - Phone:954-791-6700
Practice Address - Fax:954-797-7622
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 95121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice