Provider Demographics
NPI:1992847289
Name:SPENCER, DUANE ELWYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:ELWYN
Last Name:SPENCER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1855 SAN MIGUEL DRIVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5214
Mailing Address - Country:US
Mailing Address - Phone:925-937-7000
Mailing Address - Fax:925-937-7574
Practice Address - Street 1:1855 SAN MIGUEL DRIVE
Practice Address - Street 2:SUITE 9
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5214
Practice Address - Country:US
Practice Address - Phone:925-937-7000
Practice Address - Fax:925-937-7574
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA184141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry