Provider Demographics
NPI:1760675730
Name:JOSEPH F. SPERA, D.M.D., P.A.
Entity Type:Organization
Organization Name:JOSEPH F. SPERA, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:SPERA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-475-1122
Mailing Address - Street 1:2101 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4710
Mailing Address - Country:US
Mailing Address - Phone:302-475-1122
Mailing Address - Fax:302-475-1151
Practice Address - Street 1:2101 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4710
Practice Address - Country:US
Practice Address - Phone:302-475-1122
Practice Address - Fax:302-475-1151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPH F. SPERA, D.M.D., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-23
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG-1-0011581223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG01019Medicare UPIN