Provider Demographics
NPI:1093814741
Name:SPITZER, JAY B (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:B
Last Name:SPITZER
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 1:3312 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4118
Mailing Address - Country:US
Mailing Address - Phone:804-747-0105
Mailing Address - Fax:804-747-7363
Practice Address - Street 1:3312 N PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4118
Practice Address - Country:US
Practice Address - Phone:804-747-0105
Practice Address - Fax:804-747-7363
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA050291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice