Provider Demographics
NPI:1598258931
Name:SPRAGG, CASSANDRA JANELL (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:JANELL
Last Name:SPRAGG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 WHITNEY SOUTH CT
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6549
Mailing Address - Country:US
Mailing Address - Phone:770-286-2892
Mailing Address - Fax:
Practice Address - Street 1:1569 JANMAR RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5780
Practice Address - Country:US
Practice Address - Phone:770-979-7923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0156431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice