Provider Demographics
NPI:1275754913
Name:SPRADLIN, D. MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:D.
Middle Name:MICHAEL
Last Name:SPRADLIN
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 1:6565 S. YALE AVE. STE.1100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8346
Mailing Address - Country:US
Mailing Address - Phone:918-481-4925
Mailing Address - Fax:918-481-4931
Practice Address - Street 1:6565 S. YALE AVE. STE.1100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8346
Practice Address - Country:US
Practice Address - Phone:918-481-4925
Practice Address - Fax:918-481-4931
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice