Provider Demographics
NPI:1952751950
Name:SPRUILL, HOWARD RUSSELL III (DMD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:RUSSELL
Last Name:SPRUILL
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 FAIRFIELD LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1716
Mailing Address - Country:US
Mailing Address - Phone:908-642-1067
Mailing Address - Fax:
Practice Address - Street 1:4736 NESHAMINY BLVD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1038
Practice Address - Country:US
Practice Address - Phone:215-750-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02639001223G0001X
PADS042953122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist