Provider Demographics
NPI:1710141676
Name:HINCKLEY, SPENCER P (DDS)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:P
Last Name:HINCKLEY
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 1:707 24TH AVE SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3987
Mailing Address - Country:US
Mailing Address - Phone:405-329-7936
Mailing Address - Fax:405-329-1722
Practice Address - Street 1:707 24TH AVE SW
Practice Address - Street 2:SUITE 100
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3987
Practice Address - Country:US
Practice Address - Phone:405-329-7936
Practice Address - Fax:405-329-1722
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60161223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics