MEDICARE: DR. HARRISON ISAAC SPATZ DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	061751	NY
2	1223P0700X	Prosthodontics	DS043876	PA

General Provider Information

NPI Number	:	1821688169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRISON ISAAC SPATZ DMD

Provider Business Mailing Address
First Line	:	15 ASH DR
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-2205
Country	:	US
Telephone Number	:	516-621-9648
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 FLORAL VALE BLVD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-5525
Country	:	US
Telephone Number	:	215-860-0585
Fax Number	:	215-860-2214

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2021
Last Update Date	:	01/05/2026

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