Provider Demographics
NPI:1053364638
Name:SPILLER, MARTIN S (DMD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:S
Last Name:SPILLER
Suffix:
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:PO BOX 689
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-0689
Mailing Address - Country:US
Mailing Address - Phone:978-597-5541
Mailing Address - Fax:978-597-8982
Practice Address - Street 1:208 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MA
Practice Address - Zip Code:01469-1096
Practice Address - Country:US
Practice Address - Phone:978-597-5541
Practice Address - Fax:978-597-8982
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice