Provider Demographics
NPI:1548556251
Name:SPENCER, HARVEY L JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:L
Last Name:SPENCER
Suffix:JR
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 1:200 GRIMBALL LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-6905
Mailing Address - Country:US
Mailing Address - Phone:615-225-0700
Mailing Address - Fax:615-225-0701
Practice Address - Street 1:1747 MEDICAL CENTER PKWY
Practice Address - Street 2:STE 300
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2563
Practice Address - Country:US
Practice Address - Phone:615-225-0700
Practice Address - Fax:615-225-0701
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice