Provider Demographics
NPI:1225222649
Name:SPENCER DENTAL
Entity Type:Organization
Organization Name:SPENCER DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-910-2800
Mailing Address - Street 1:1611 SPENCER HWY STE H
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77587-3772
Mailing Address - Country:US
Mailing Address - Phone:713-910-2800
Mailing Address - Fax:713-310-2801
Practice Address - Street 1:1611 SPENCER HWY STE H
Practice Address - Street 2:
Practice Address - City:SOUTH HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77587-3772
Practice Address - Country:US
Practice Address - Phone:713-910-2800
Practice Address - Fax:713-310-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty