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Mr. Larry Lee Pevny, DENTURIST
Denturist in Marysville, Washington
NPI 1194960161

Larry Lee Pevny is a Denturist based in Marysville, WA. Larry Lee Pevny practices in Marysville, WA and has the professional credentials of DENTURIST. The NPI Number for Larry Lee Pevny is 1194960161 and holds a License No. DN00000045 (Washington).

The current practice location address for Larry Lee Pevny is 619 Cedar Ave, Marysville, WA and can be reached out via phone at 360-659-6300 and via fax at 360-691-7881.

Location: 619 Cedar Ave, Marysville, WA, 98270-4532
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194960161
Provider Name
Larry Lee Pevny
Credential
DENTURIST
Provider Entity Type
Individual
Gender
Male
Address
619 Cedar Ave, Marysville, WA, 98270-4532
Phone Number
360-659-6300
Fax Number
360-691-7881
Provider Enumeration Date
12/04/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1336278910 01 WA ORGANIZATIONAL NPI NUMBER
institution
Provider Business Practice Location Address Details
Address
619 Cedar Ave
City
Marysville
State
Washington
Zip
98270-4532
Phone Number
360-659-6300
Fax Number
360-691-7881
person
Provider Business Mailing Address Details
Address
619 Cedar Ave
City
Marysville
State
Washington
Zip
98270-4532
Phone Number
360-659-6300
Fax Number
360-691-7881
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
122400000X
License No.
DN00000045 (Washington)
Definition
Definition to come.
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