Provider Demographics
NPI:1457523680
Name:SPURGEON, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SPURGEON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:SPURGEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:222 S SUMMIT AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-3780
Mailing Address - Country:US
Mailing Address - Phone:928-445-2440
Mailing Address - Fax:
Practice Address - Street 1:222 S SUMMIT AVE STE 2
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-3780
Practice Address - Country:US
Practice Address - Phone:928-445-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5571122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist