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Individual

DR. LARRY AUSTIN PRESTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2348 VOLUNTEER PARKWAY, BRISTOL, TN 37620
(423) 968-7871
(423) 968-7871
Mailing address
2348 VOLUNTEER PARKWAY, BRISTOL, TN 37620
(423) 968-7871
(423) 968-7871

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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