Provider Demographics
NPI:1285339846
Name:SPIGENER, WESLEY COLE (DDS)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:COLE
Last Name:SPIGENER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 SPIGENER RD
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-5332
Mailing Address - Country:US
Mailing Address - Phone:318-413-0548
Mailing Address - Fax:
Practice Address - Street 1:2508 BERT KOUN LOOP STE 403
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3157
Practice Address - Country:US
Practice Address - Phone:318-212-5254
Practice Address - Fax:318-212-5257
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program