Dr. Larry R Ficklin, dds
Dentist in New Haven, MO. Individual provider (NPI-1).
NPI number1962669283
StatusActive
Last updated in NPPESMay 22, 2008
Details
- NPI
- 1962669283
- Entity type
- Individual (NPI-1)
- Name
- Dr. Larry R Ficklin
- Credential
- dds
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 22, 2008
- Last updated
- May 22, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 012855 | MO | Yes |
Practice location
104 Miller StNew Haven, MO 63068-1143
Phone 573-237-3038 · Fax 573-237-2987
Mailing address
104 Miller StNew Haven, MO 63068-1143
Phone 573-237-3038 · Fax 573-237-2987
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