MEDICARE: REBECCA LYNN SPEARMAN DDS

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	1223G0001X	General Practice Dentistry	4425	AR

General Provider Information

NPI Number	:	1972063386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA LYNN SPEARMAN DDS

Provider Business Mailing Address
First Line	:	9 RED OAK PL
Second Line	:
City	:	MAUMELLE
State	:	AR
Zip	:	72113-6805
Country	:	US
Telephone Number	:	479-886-5526
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 DAVE WARD DR STE 103
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-7040
Country	:	US
Telephone Number	:	501-932-0192
Fax Number	:

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

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	07/19/2023

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