Provider Demographics
NPI:1407055452
Name:LUKE, SPENCER D (DMD)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:D
Last Name:LUKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116-1600
Mailing Address - Country:US
Mailing Address - Phone:801-596-3000
Mailing Address - Fax:801-596-8887
Practice Address - Street 1:1011 N CATHERINE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-1600
Practice Address - Country:US
Practice Address - Phone:801-596-3000
Practice Address - Fax:801-596-8887
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT63217271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice