Provider Demographics
NPI:1275966020
Name:ROEDER, BRITTANY SPANJER (DDS)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SPANJER
Last Name:ROEDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:KARI
Other - Last Name:SPANJER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1103 S SHIELDS ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4524
Mailing Address - Country:US
Mailing Address - Phone:847-977-6680
Mailing Address - Fax:
Practice Address - Street 1:1103 S SHIELDS ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4524
Practice Address - Country:US
Practice Address - Phone:847-977-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09030122300000X
CO203032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist