Provider Demographics
NPI:1386888295
Name:DURWOOD SPENCER DDS.PC
Entity type:Organization
Organization Name:DURWOOD SPENCER DDS.PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DURWOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-751-0255
Mailing Address - Street 1:5340 EL PASO DR STE K
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2838
Mailing Address - Country:US
Mailing Address - Phone:915-751-0255
Mailing Address - Fax:915-751-0948
Practice Address - Street 1:5340 EL PASO DR STE K
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2838
Practice Address - Country:US
Practice Address - Phone:915-751-0255
Practice Address - Fax:915-751-0948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty