Provider Demographics
NPI:1437589942
Name:SPENCER, DALE (DDS,PA)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:M
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 FAIRGROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-9695
Mailing Address - Country:US
Mailing Address - Phone:828-328-6118
Mailing Address - Fax:828-328-1657
Practice Address - Street 1:1170 FAIRGROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9695
Practice Address - Country:US
Practice Address - Phone:828-328-6118
Practice Address - Fax:828-328-1657
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC49541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice