Provider Demographics
NPI:1134163991
Name:SPRAGUE, DONALD M (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:M
Last Name:SPRAGUE
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 1:9 DOLLOFF DAM RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03290-4915
Mailing Address - Country:US
Mailing Address - Phone:603-895-3408
Mailing Address - Fax:
Practice Address - Street 1:1 HAMPTON RD
Practice Address - Street 2:SUITE 305
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4848
Practice Address - Country:US
Practice Address - Phone:603-772-7874
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice