Larry W Forehand, D.D.S.
Individual provider Active NPI General Practice Dentistry · Aurora, MO
NPI 1003972126 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003972126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12078 (MO)
- Practice address
- 1402 S Elliott Ave
Aurora, MO 65605-2104 - Phone
- (417) 678-5055
- Fax
- (417) 678-2460
- NPI assigned
- Jan 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12078 | MO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12078 | MO | Yes |
Addresses
Primary practice location
1402 S Elliott Ave
Aurora, MO 65605-2104
Mailing address
1402 S Elliott Ave
Aurora, MO 65605-2104
Phone (417) 678-5055
Other providers in Aurora, MO
- Linda Donnelson
- Monica J Dummit
- John Tucker Dunham
- Heather Edwards
- William E. Finfrock
- Richard Alan Freitas
- Benjamin T Gallion
- Bradford P Garner
- Haley Goodloe
- Cindi Sue Grace
All providers in Aurora, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.