Individual
LARRY D SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
312 N MAIN, WEST, TX 76691-0369
(254) 826-4067
(254) 826-4589
Mailing address
PO BOX 369, 312 N MAIN, WEST, TX 76691-0369
(254) 826-4067
(254) 826-4589
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
TX14129
TX
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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