Provider Demographics
NPI:1023005923
Name:PARWORTH, LARRY PAUL (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:PAUL
Last Name:PARWORTH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 CORK ST
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-1110
Mailing Address - Country:US
Mailing Address - Phone:828-989-8784
Mailing Address - Fax:
Practice Address - Street 1:307 S BROAD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-2119
Practice Address - Country:US
Practice Address - Phone:678-345-1014
Practice Address - Fax:678-345-1018
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC62501223S0112X
GADN1228501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery