Provider Demographics
NPI:1992756647
Name:COMMONS, LARRANCE LESLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:LARRANCE
Middle Name:LESLEY
Last Name:COMMONS
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 1:17500 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-3769
Mailing Address - Country:US
Mailing Address - Phone:206-363-2300
Mailing Address - Fax:206-367-3880
Practice Address - Street 1:17500 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3769
Practice Address - Country:US
Practice Address - Phone:206-363-2300
Practice Address - Fax:206-367-3880
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist