Individual
LARRY A WOODS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
208 N WASHINGTON ST, TULLAHOMA, TN 37388-3649
(931) 455-3917
Mailing address
208 N WASHINGTON ST, TULLAHOMA, TN 37388-3649
(931) 455-3917
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000006921
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0168896
BLUE CROSS BLUE SHIELD
TN
05
—
3225947
—
TN
Enumeration date
01/18/2006
Last updated
07/09/2007
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