Provider Demographics
NPI:1528289154
Name:J. DON SPILLERS, JR., DMD, MS, PC
Entity type:Organization
Organization Name:J. DON SPILLERS, JR., DMD, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:SPILLERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:478-953-2700
Mailing Address - Street 1:400 SPILLERS WAY
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-0512
Mailing Address - Country:US
Mailing Address - Phone:478-953-2700
Mailing Address - Fax:478-953-2710
Practice Address - Street 1:400 SPILLERS WAY
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-0512
Practice Address - Country:US
Practice Address - Phone:478-953-2700
Practice Address - Fax:478-953-2710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0110231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty