Provider Demographics
NPI:1598703308
Name:THURGOOD, A. SPENCER (DDS)
Entity Type:Individual
Prefix:DR
First Name:A.
Middle Name:SPENCER
Last Name:THURGOOD
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 1:2414 W 7800 S
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-4292
Mailing Address - Country:US
Mailing Address - Phone:801-566-0631
Mailing Address - Fax:801-566-4826
Practice Address - Street 1:2414 W 7800 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-4292
Practice Address - Country:US
Practice Address - Phone:801-566-0631
Practice Address - Fax:801-566-4826
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1322671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice