Provider Demographics
NPI:1780425900
Name:SPRANGER, GRANT RAE (DDS)
Entity type:Individual
Prefix:DR
First Name:GRANT
Middle Name:RAE
Last Name:SPRANGER
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 1:2202 HOUSER ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2306
Mailing Address - Country:US
Mailing Address - Phone:563-500-1069
Mailing Address - Fax:
Practice Address - Street 1:2202 HOUSER ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2306
Practice Address - Country:US
Practice Address - Phone:563-500-1069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-102071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice