Provider Demographics
NPI:1235341660
Name:SPRUILL & WONG DDS PC
Entity Type:Organization
Organization Name:SPRUILL & WONG DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-245-0061
Mailing Address - Street 1:520 S PITT ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3820
Mailing Address - Country:US
Mailing Address - Phone:717-245-0061
Mailing Address - Fax:717-245-0282
Practice Address - Street 1:520 S PITT ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3820
Practice Address - Country:US
Practice Address - Phone:717-245-0061
Practice Address - Fax:717-245-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 021643 L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty