Provider Demographics
NPI:1831197516
Name:SPENCE, DOYLE SAM (DDS)
Entity type:Individual
Prefix:DR
First Name:DOYLE
Middle Name:SAM
Last Name:SPENCE
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 1:3390 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6224
Mailing Address - Country:US
Mailing Address - Phone:325-695-0088
Mailing Address - Fax:325-695-7778
Practice Address - Street 1:3390 S 27TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6224
Practice Address - Country:US
Practice Address - Phone:325-695-0088
Practice Address - Fax:325-695-7778
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0089013-01Medicaid