Individual
LARRY DOUGLAS SHEETRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
623 N 9TH ST, AUGUSTA, AR 72006-2129
(870) 347-3300
(870) 347-3492
Mailing address
623 N 9TH ST, AUGUSTA, AR 72006-2129
(870) 347-3300
(870) 347-3492
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2307
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167415608
—
AR
Enumeration date
03/14/2008
Last updated
09/09/2008
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