Provider Demographics
NPI:1992971683
Name:JOHN F. LARGEN, D.M.D., P.A.
Entity type:Organization
Organization Name:JOHN F. LARGEN, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:LARGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-846-9040
Mailing Address - Street 1:12651 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-0906
Mailing Address - Country:US
Mailing Address - Phone:954-846-9040
Mailing Address - Fax:954-846-1363
Practice Address - Street 1:12651 W SUNRISE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-0906
Practice Address - Country:US
Practice Address - Phone:954-846-9040
Practice Address - Fax:954-846-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty