Individual
DR. LARRY TABATCHNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
2409 ROBESON ST, FAYETTEVILLE, NC 28305-5549
(910) 483-9546
(910) 483-8550
Mailing address
2409 ROBESON ST, FAYETTEVILLE, NC 28305-5549
(910) 483-9546
(910) 483-8550
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8750
NC
Other
Enumeration date
09/29/2005
Last updated
08/25/2009
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