Provider Demographics
NPI:1437124278
Name:CROOK, SPENCER W (DMD MS)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:W
Last Name:CROOK
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 N 32ND ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7154
Mailing Address - Country:US
Mailing Address - Phone:623-748-1345
Mailing Address - Fax:623-505-3678
Practice Address - Street 1:7972 W THUNDERBIRD RD
Practice Address - Street 2:SUITE #103
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4903
Practice Address - Country:US
Practice Address - Phone:623-979-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD59151223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics