Individual
DR. LARRY J. LAVELETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
443 12TH AVE. N.E., NORMAN, OK 73071-5241
(405) 360-0018
(405) 360-1178
Mailing address
443 12TH AVE NE, NORMAN, OK 73071-5241
(405) 360-0018
(405) 360-1178
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4835
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4835
BLUE CROSS/BLUE SHIELD FEDERAL
—
Enumeration date
08/14/2006
Last updated
05/14/2008
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