Provider Demographics
NPI:1104857440
Name:SPIEKER, HARVEY DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:DEAN
Last Name:SPIEKER
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 1:312 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:SD
Mailing Address - Zip Code:57225-1405
Mailing Address - Country:US
Mailing Address - Phone:605-532-3636
Mailing Address - Fax:605-532-3934
Practice Address - Street 1:312 1ST AVE W
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:SD
Practice Address - Zip Code:57225-1405
Practice Address - Country:US
Practice Address - Phone:605-532-3636
Practice Address - Fax:605-532-3934
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM4351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice