Provider Demographics
NPI:1124125323
Name:MICHAEL D. SPRENG, DDS, INC.
Entity type:Organization
Organization Name:MICHAEL D. SPRENG, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPRENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-289-1813
Mailing Address - Street 1:910 KATHERINE AVE STE A
Mailing Address - Street 2:P.O. BOX 602
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3692
Mailing Address - Country:US
Mailing Address - Phone:419-289-1813
Mailing Address - Fax:419-281-8279
Practice Address - Street 1:910 KATHERINE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3692
Practice Address - Country:US
Practice Address - Phone:419-289-1813
Practice Address - Fax:419-281-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH166021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty