Individual
DR. LARRY EDISON BAUCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
305 PAGE RD. NORTH, PINEHURST, NC 28374
(910) 295-1010
(910) 295-1367
Mailing address
PO BOX 789, PINEHURST, NC 28370-0789
(910) 295-1010
(910) 295-1367
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3258
NC
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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