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Individual
DR. LARRY AUSTIN PRESTON
Active
Individual
DR. LARRY AUSTIN PRESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3204
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161023
BCBS TN
TN
01
—
036969
ANTHEMBCBS VA
VA
05
—
3225468
—
TN
Enumeration date
10/04/2006
Last updated
07/08/2007
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