Individual
DR. LARRY J SKOCZYLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
6112 MERLIN CT, MIDLAND, MI 48640-7358
(989) 839-9979
(989) 839-9553
Mailing address
6112 MERLIN CT, MIDLAND, MI 48640-7358
(989) 839-9979
(989) 839-9553
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
LS014616
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
LS014616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2847912
—
MI
05
—
2993779
—
MI
Enumeration date
07/13/2006
Last updated
10/10/2012
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