Provider Demographics
NPI:1346432861
Name:E. TRACY SPAUR DDS
Entity Type:Organization
Organization Name:E. TRACY SPAUR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:TRACY
Authorized Official - Last Name:SPAUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-598-3500
Mailing Address - Street 1:P O BOX 335
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139
Mailing Address - Country:US
Mailing Address - Phone:804-598-3500
Mailing Address - Fax:
Practice Address - Street 1:3852 OLD BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-7019
Practice Address - Country:US
Practice Address - Phone:804-598-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5786122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty