Provider Demographics
NPI:1982985503
Name:DENNA, SPENCER (PHARMD)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:DENNA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85244-0102
Mailing Address - Country:US
Mailing Address - Phone:801-230-0146
Mailing Address - Fax:
Practice Address - Street 1:975 E OCOTILLO RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-3013
Practice Address - Country:US
Practice Address - Phone:480-214-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist