Dormois, Larry D

Dormois, Larry D is an individual health care provider with primary practice located at 875 Union Ave , Memphis TN 38103. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Dormois, Larry D can be contacted via phone (901) 448-6240.

Contact Information

Primary practice address
875 Union Ave Memphis TN 38103
Phone: (901) 448-6240
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 2335 Mississippi
Dental Providers / Pediatric Dentistry 1223P0221X 3545 Tennessee

Profile Details

NPI number 1386700839
LBN Legal business name Dormois, Larry D
Credentials D.D.S, M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Aug 27th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386700839 NPPES
Tennessee Other 4031775 BCBS TN PROVIDER
Tennessee MEDICAID 6049 BCBS TN PROVIDER
Tennessee MEDICAID 109831608 BCBS TN PROVIDER

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