Individual
LARRY EDWARD COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
RT 52 MAIN STREET, GILBERT, GILBERT, WV 25621
(304) 664-8163
(304) 664-8193
Mailing address
PO BOX 1298, GILBERT, WV 25621-1298
(304) 664-8163
(304) 664-8193
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2991
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133824000
—
WV
Enumeration date
11/23/2010
Last updated
11/23/2010
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