Organization
LARRY G PAYNE DDS LC
Active
Other names
Waterloo Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA J PAYNE (VICE PRESIDENT/ OFFICE MANAGER)
(260) 837-2138
Entity
Organization
Contact information
Practice address
605 S WAYNE ST, WATERLOO, IN 46793-9472
(260) 837-2138
(260) 837-7481
Mailing address
605 S WAYNE ST, WATERLOO, IN 46793-9472
(260) 837-2138
(260) 837-7481
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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