Provider Demographics
NPI:1144358268
Name:AKIN, LARRY D (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
Last Name:AKIN
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 N BERNARD ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2617
Mailing Address - Country:US
Mailing Address - Phone:307-754-3391
Mailing Address - Fax:
Practice Address - Street 1:175 N BERNARD ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2617
Practice Address - Country:US
Practice Address - Phone:307-754-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY8491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY0001805075OtherDEPT. OF EMPLOYMENT NUMBE