Provider Demographics
NPI:1326137597
Name:SPATAFORE, CLARA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:M
Last Name:SPATAFORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CLARA
Other - Middle Name:M
Other - Last Name:SPATAFORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:2593 WEXFORD BAYNE RD
Mailing Address - Street 2:STE 304
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8608
Mailing Address - Country:US
Mailing Address - Phone:724-940-3963
Mailing Address - Fax:724-940-3965
Practice Address - Street 1:2593 WEXFORD BAYNE RD
Practice Address - Street 2:STE 304
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8608
Practice Address - Country:US
Practice Address - Phone:724-940-3963
Practice Address - Fax:724-940-3965
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023991L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics