Healthcare Provider Details

I. General information

NPI: 1114097268
Provider Name (Legal Business Name): BRIAN SCOTT SPRAYBERRY D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

773 N DEAN RD
AUBURN AL
36830-4027
US

IV. Provider business mailing address

773 N DEAN RD
AUBURN AL
36830-4027
US

V. Phone/Fax

Practice location:
  • Phone: 334-821-5031
  • Fax: 334-821-7037
Mailing address:
  • Phone: 334-821-5031
  • Fax: 334-821-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4816
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: