Provider Demographics
NPI:1457933822
Name:MARSH, SPENCER (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:
Last Name:MARSH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1196 STOCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9169
Mailing Address - Country:US
Mailing Address - Phone:585-330-4941
Mailing Address - Fax:
Practice Address - Street 1:7780 BRIER CREEK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7850
Practice Address - Country:US
Practice Address - Phone:919-676-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC121681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics