Provider Demographics
NPI:1144255803
Name:GITLIN, LARRY M (DDS)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:M
Last Name:GITLIN
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 1:11757 W KEN CARYL AVE
Mailing Address - Street 2:#J
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3719
Mailing Address - Country:US
Mailing Address - Phone:303-979-9488
Mailing Address - Fax:
Practice Address - Street 1:11757 W KEN CARYL AVE
Practice Address - Street 2:#J
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3719
Practice Address - Country:US
Practice Address - Phone:303-979-9488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO007491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice