Provider Demographics
NPI:1225221690
Name:DR. JFFERY A. SPILMAN DDS
Entity Type:Organization
Organization Name:DR. JFFERY A. SPILMAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SPILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-321-1427
Mailing Address - Street 1:4899 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7217
Mailing Address - Country:US
Mailing Address - Phone:727-321-1427
Mailing Address - Fax:727-328-1185
Practice Address - Street 1:4899 5TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7217
Practice Address - Country:US
Practice Address - Phone:727-321-1427
Practice Address - Fax:727-328-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16221305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization