Provider Demographics
NPI:1619188653
Name:SPILLANE, DENNIS T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:T
Last Name:SPILLANE
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 1:6668 BERNIE KOHLER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48461-8885
Mailing Address - Country:US
Mailing Address - Phone:810-688-3047
Mailing Address - Fax:810-688-3109
Practice Address - Street 1:6668 BERNIE KOHLER DR
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48461-8885
Practice Address - Country:US
Practice Address - Phone:810-688-3047
Practice Address - Fax:810-688-3109
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010138541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice