Individual
DR. LARRY MIKE BLOODSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 MAGNOLIA DRIVE, TYLER, TX 75701
(903) 595-2707
Mailing address
1001 MAGNOLIA DRIVE, TYLER, TX 75701
(903) 595-2707
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11305
TX
Other
Enumeration date
08/28/2006
Last updated
07/08/2007
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