DR. Larry Mike Bloodsworth, DDS

NPI #1013025121 in Tyler, Texas

Provider Information

NPI Number: 1013025121
Entity Type: Individual
Name: DR. Larry Mike Bloodsworth, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Aug 28, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1001 MAGNOLIA DRIVE
City: Tyler
State: Texas
ZIP Code: 75701
Phone: (903) 595-2707

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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