Larry Jack, DDS
NPI 1386982247 · on the registry since 2013 · sole proprietor
Practice
- Address
- 404 E 7th St
Leadville, CO 80461 - Phone
- (410) 980-5433
Registry record
- Primary taxonomy
- Dentist
122300000X
- Also registered as
- Dentist
- Licence states on file
- CO, MD
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-01-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado