Provider Demographics
NPI:1598821530
Name:SPEARS, DAN (DDS)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:SPEARS
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 1:11939 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-1238
Mailing Address - Country:US
Mailing Address - Phone:714-891-0600
Mailing Address - Fax:714-898-3705
Practice Address - Street 1:11939 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1238
Practice Address - Country:US
Practice Address - Phone:714-891-0600
Practice Address - Fax:714-898-3705
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice