Provider Demographics
NPI:1043387020
Name:SPILLMAN, KENT J (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:J
Last Name:SPILLMAN
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 1:7502 WEST 80TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2147
Mailing Address - Country:US
Mailing Address - Phone:303-424-7757
Mailing Address - Fax:303-403-0268
Practice Address - Street 1:7502 WEST 80TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2147
Practice Address - Country:US
Practice Address - Phone:303-424-7757
Practice Address - Fax:303-403-0268
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1047481223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics