Provider Demographics
NPI:1568546075
Name:SPAGNESI, PHILIP A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:A
Last Name:SPAGNESI
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 1:449 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1323
Mailing Address - Country:US
Mailing Address - Phone:201-265-8600
Mailing Address - Fax:
Practice Address - Street 1:449 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1323
Practice Address - Country:US
Practice Address - Phone:201-265-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI013191001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice