Individual
LARRY D LEEMASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3001 S TELEPHONE RD, SUITE A, MOORE, OK 73160-2942
(405) 793-8300
(405) 793-8397
Mailing address
3001 S TELEPHONE RD, SUITE A, MOORE, OK 73160-2942
(405) 793-8300
(405) 793-8397
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4856
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089760A
—
OK
Enumeration date
01/30/2008
Last updated
08/31/2011
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