Provider Demographics
NPI:1548218977
Name:SPADER, GEORGE JOOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOOSEPH
Last Name:SPADER
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 1:7437 JACKMAN RD
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9223
Mailing Address - Country:US
Mailing Address - Phone:734-847-1780
Mailing Address - Fax:734-847-2080
Practice Address - Street 1:7437 JACKMAN RD
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-9223
Practice Address - Country:US
Practice Address - Phone:734-847-1780
Practice Address - Fax:734-847-2080
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI13955122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist