Provider Demographics
NPI:1427017003
Name:STCYR, SPENCER SEAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:SEAN
Last Name:STCYR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5973 CECIL WAY
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8576
Mailing Address - Country:US
Mailing Address - Phone:410-795-0101
Mailing Address - Fax:410-795-0165
Practice Address - Street 1:6351 OKLAHOMA RD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6620
Practice Address - Country:US
Practice Address - Phone:410-795-0101
Practice Address - Fax:410-795-0165
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice