Provider Demographics
NPI:1275984767
Name:SPENCER, ERIN MARIE (DMD)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:MARIE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 GALLATIN PIKE N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2003
Mailing Address - Country:US
Mailing Address - Phone:615-953-8946
Mailing Address - Fax:
Practice Address - Street 1:2153 GALLATIN PIKE N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2003
Practice Address - Country:US
Practice Address - Phone:615-953-8946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-26
Last Update Date:2016-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10267122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist