Provider Demographics
NPI:1760179592
Name:SPRESSER, WYATT JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:WYATT
Middle Name:JAMES
Last Name:SPRESSER
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 1:3200 MCKINNEY AVE APT 530
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2546
Mailing Address - Country:US
Mailing Address - Phone:719-648-8911
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD # CS3.104
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-645-3979
Practice Address - Fax:214-648-7620
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program