Provider Demographics
NPI:1578611604
Name:SPANNHAKE, ELIZABETH BOSSONG (DDS, MS, MPH)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:BOSSONG
Last Name:SPANNHAKE
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Gender:F
Credentials:DDS, MS, MPH
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Mailing Address - Street 1:419 MALCOLM DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6130
Mailing Address - Country:US
Mailing Address - Phone:410-857-4700
Mailing Address - Fax:410-857-9166
Practice Address - Street 1:419 MALCOLM DR
Practice Address - Street 2:SUITE C
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6130
Practice Address - Country:US
Practice Address - Phone:410-857-4700
Practice Address - Fax:410-857-9166
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD80261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics