Provider Demographics
NPI:1538345095
Name:HEARIN, LARRY E (DDS)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:E
Last Name:HEARIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:501 LAPEER
Mailing Address - Street 2:HEALTH DELIVERY INC.
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607
Mailing Address - Country:US
Mailing Address - Phone:989-759-6400
Mailing Address - Fax:989-759-6423
Practice Address - Street 1:3884 MONITOR ROAD
Practice Address - Street 2:BAYSIDE COMMUNITY HEALTH CENTER
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-671-2000
Practice Address - Fax:989-686-0638
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101331223G0001X
MI29010101331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538345095OtherDELTA DENTAL