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Organization

BEVERLY A LARGENT, D.M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BEVERLY LARGENT (OWNER/DENTIST)
(270) 554-5437
Entity
Organization

Contact information

Practice address
3008 OREGON ST, PADUCAH, KY 42001-5651
(270) 554-5437
(270) 554-5236
Mailing address
3008 OREGON ST, PADUCAH, KY 42001-5651
(270) 554-5437
(270) 554-5236

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5466
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60054665
KY
05
7100001640
KY
Enumeration date
09/21/2007
Last updated
01/23/2013
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