Provider Demographics
NPI:1891232120
Name:SPENCER D WEED DDS PLLC
Entity Type:Organization
Organization Name:SPENCER D WEED DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-374-2400
Mailing Address - Street 1:11631 E NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4203
Mailing Address - Country:US
Mailing Address - Phone:520-374-2400
Mailing Address - Fax:520-836-7469
Practice Address - Street 1:11631 E NAVAJO DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249
Practice Address - Country:US
Practice Address - Phone:520-374-2400
Practice Address - Fax:520-836-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7244122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty