Provider Demographics
NPI:1053572982
Name:SPENCER, LAURAN RUTH (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURAN
Middle Name:RUTH
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MIDTOWN PL
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6348
Mailing Address - Country:US
Mailing Address - Phone:405-834-1312
Mailing Address - Fax:405-733-8296
Practice Address - Street 1:9060 HARMONY DR
Practice Address - Street 2:SUITE D
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6218
Practice Address - Country:US
Practice Address - Phone:405-132-1012
Practice Address - Fax:405-733-8296
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice