Provider Demographics
NPI:1194345785
Name:GREG SPIELMANN LLC
Entity type:Organization
Organization Name:GREG SPIELMANN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-848-7780
Mailing Address - Street 1:2816 NW 58TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6899
Mailing Address - Country:US
Mailing Address - Phone:405-848-7780
Mailing Address - Fax:405-848-7780
Practice Address - Street 1:2816 NW 58TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6899
Practice Address - Country:US
Practice Address - Phone:405-848-7780
Practice Address - Fax:405-848-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental