Provider Demographics
NPI:1194145227
Name:ARMUTH, SPENCER (DMD MD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:ARMUTH
Suffix:
Gender:M
Credentials:DMD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W CHARLESTON BLVD STE 520
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2309
Mailing Address - Country:US
Mailing Address - Phone:702-750-9444
Mailing Address - Fax:
Practice Address - Street 1:1701 W CHARLESTON BLVD STE 520
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2309
Practice Address - Country:US
Practice Address - Phone:702-750-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS2-1721223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty