Provider Demographics
NPI:1316911324
Name:SPELMAN, STEPHEN WINTHER (DDS, FAGD)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WINTHER
Last Name:SPELMAN
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 S HUALAPAI WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7707
Mailing Address - Country:US
Mailing Address - Phone:702-871-6044
Mailing Address - Fax:
Practice Address - Street 1:3450 S HUALAPAI WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7707
Practice Address - Country:US
Practice Address - Phone:702-871-6044
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice