Provider Demographics
NPI: | 1053340109 |
---|---|
Name: | SPANGLER, LAMBERT AND LIPP, DDS, PLLC |
Entity type: | Organization |
Organization Name: | SPANGLER, LAMBERT AND LIPP, DDS, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATIVE ASSISTANT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RUTH |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | MCDOWELL DAUGHTRY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-768-1332 |
Mailing Address - Street 1: | 1544 N PEACE HAVEN RD |
Mailing Address - Street 2: | |
Mailing Address - City: | WINSTON SALEM |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27104-1328 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-768-1332 |
Mailing Address - Fax: | 336-768-9470 |
Practice Address - Street 1: | 1544 N PEACE HAVEN RD |
Practice Address - Street 2: | |
Practice Address - City: | WINSTON SALEM |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27104-1328 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-768-1332 |
Practice Address - Fax: | 336-768-9470 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-01 |
Last Update Date: | 2024-10-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1223P0221X | Dental Providers | Dentist | Pediatric Dentistry | Group - Single Specialty |