Provider Demographics
NPI:1992826598
Name:SPIVEY, JAMES DALE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DALE
Last Name:SPIVEY
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 1:278 LAFAYETTE RD
Mailing Address - Street 2:BUILDING E
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5455
Mailing Address - Country:US
Mailing Address - Phone:603-436-7787
Mailing Address - Fax:603-430-8597
Practice Address - Street 1:278 LAFAYETTE RD
Practice Address - Street 2:BUILDING E
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5455
Practice Address - Country:US
Practice Address - Phone:603-436-7787
Practice Address - Fax:603-430-8597
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics