Provider Demographics
NPI:1265735732
Name:SPECHT, TOMMY STEPHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:STEPHEN
Last Name:SPECHT
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 1:522 13TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-7238
Mailing Address - Country:US
Mailing Address - Phone:805-237-7773
Mailing Address - Fax:805-238-1863
Practice Address - Street 1:522 13TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-7238
Practice Address - Country:US
Practice Address - Phone:805-237-7773
Practice Address - Fax:805-238-1863
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice