Provider Demographics
NPI:1487675849
Name:SPANGLER, SETH
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7086 HIGHLAND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3768
Mailing Address - Country:US
Mailing Address - Phone:801-942-5520
Mailing Address - Fax:
Practice Address - Street 1:7086 HIGHLAND DR STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3768
Practice Address - Country:US
Practice Address - Phone:801-942-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5357672-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice