Provider Demographics
NPI:1336217017
Name:BEN C SPAULDING DDS PC
Entity Type:Organization
Organization Name:BEN C SPAULDING DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-728-4143
Mailing Address - Street 1:1056 MCARTHUR STREET
Mailing Address - Street 2:BEN C SPAULDING DDS PC
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355
Mailing Address - Country:US
Mailing Address - Phone:931-728-4143
Mailing Address - Fax:931-728-8209
Practice Address - Street 1:1056 MCARTHUR STREET
Practice Address - Street 2:BEN C SPAULDING DDS PC
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355
Practice Address - Country:US
Practice Address - Phone:931-728-4143
Practice Address - Fax:931-728-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS1454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty