Provider Demographics
NPI:1740316744
Name:FRIED, SPENCER L (DDS)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:L
Last Name:FRIED
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 1:800 COMPTON RD
Mailing Address - Street 2:SUITE 22
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3826
Mailing Address - Country:US
Mailing Address - Phone:513-522-3377
Mailing Address - Fax:513-522-1605
Practice Address - Street 1:800 COMPTON RD
Practice Address - Street 2:SUITE 22
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3826
Practice Address - Country:US
Practice Address - Phone:513-522-3377
Practice Address - Fax:513-522-1605
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH126741223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics