Provider Demographics
NPI:1124191358
Name:SAINT-CYR, SPENCER CARL (DMD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:CARL
Last Name:SAINT-CYR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 E MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3382
Mailing Address - Country:US
Mailing Address - Phone:877-422-6257
Mailing Address - Fax:856-206-9254
Practice Address - Street 1:2311 NEW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1442
Practice Address - Country:US
Practice Address - Phone:877-422-6257
Practice Address - Fax:856-797-5733
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0207161223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics