Provider Demographics
NPI:1972773869
Name:CHESTER SPENCER,DDS,MSD,&ASSOCIATES
Entity Type:Organization
Organization Name:CHESTER SPENCER,DDS,MSD,&ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS,MSD
Authorized Official - Phone:972-660-5522
Mailing Address - Street 1:2630 S CARRIER PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-5069
Mailing Address - Country:US
Mailing Address - Phone:972-660-5522
Mailing Address - Fax:
Practice Address - Street 1:2630 S CARRIER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-5069
Practice Address - Country:US
Practice Address - Phone:972-660-5522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty