Provider Demographics
NPI:1528384112
Name:DURWOOD SPENCER DDS PC
Entity Type:Organization
Organization Name:DURWOOD SPENCER DDS PC
Other - Org Name:HERSHEY'S DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-751-0255
Mailing Address - Street 1:5340 EL PASO DR
Mailing Address - Street 2:SUITE K
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2837
Mailing Address - Country:US
Mailing Address - Phone:915-751-0255
Mailing Address - Fax:915-751-0948
Practice Address - Street 1:5340 EL PASO DR
Practice Address - Street 2:SUITE K
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2837
Practice Address - Country:US
Practice Address - Phone:915-751-0255
Practice Address - Fax:915-751-0948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty