Individual
LARRY C HARGREAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
314 NEOSHO ST, BURLINGTON, KS 66839-1926
(620) 364-8414
(620) 364-8416
Mailing address
314 NEOSHO ST, BURLINGTON, KS 66839-1926
(620) 364-8414
(620) 364-8416
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4836
KS
1223G0001X
General Practice Dentistry
Primary
4836
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096690
—
KS
05
—
100096690B
—
KS
Enumeration date
07/19/2006
Last updated
07/21/2022
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