Provider Demographics
NPI:1104044767
Name:EASON, DAN SPURRIER (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:SPURRIER
Last Name:EASON
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 1:2670 UNION AVENUE EXT
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-4426
Mailing Address - Country:US
Mailing Address - Phone:901-327-3800
Mailing Address - Fax:901-324-2777
Practice Address - Street 1:2670 UNION AVENUE EXT
Practice Address - Street 2:SUITE 130
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-4426
Practice Address - Country:US
Practice Address - Phone:901-327-3800
Practice Address - Fax:901-324-2777
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTNDS35661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice