Provider Demographics
NPI:1306461249
Name:JOHN J SPURR DDS PLC
Entity type:Organization
Organization Name:JOHN J SPURR DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPURR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-744-6736
Mailing Address - Street 1:9159 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-9600
Mailing Address - Country:US
Mailing Address - Phone:269-744-6736
Mailing Address - Fax:269-216-7970
Practice Address - Street 1:1624 S DRAKE RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-5780
Practice Address - Country:US
Practice Address - Phone:269-345-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental