Provider Demographics
NPI:1407867252
Name:ZAUGG, SPENCER ELWOOD (DMD)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:ELWOOD
Last Name:ZAUGG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 PINE COVE RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1333
Mailing Address - Country:US
Mailing Address - Phone:406-655-0887
Mailing Address - Fax:
Practice Address - Street 1:1139 N 27TH ST STE A
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0107
Practice Address - Country:US
Practice Address - Phone:406-245-5556
Practice Address - Fax:406-245-5694
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21121223G0001X
MO20020152021223G0001X
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice