Healthcare Provider Details

I. General information

NPI: 1760675730
Provider Name (Legal Business Name): JOSEPH F. SPERA, D.M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 FOULK RD
WILMINGTON DE
19810-4710
US

IV. Provider business mailing address

2101 FOULK RD
WILMINGTON DE
19810-4710
US

V. Phone/Fax

Practice location:
  • Phone: 302-475-1122
  • Fax: 302-475-1151
Mailing address:
  • Phone: 302-475-1122
  • Fax: 302-475-1151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberG-1-001158
License Number StateDE

VIII. Authorized Official

Name: DR. JOSEPH F SPERA
Title or Position: OWNER
Credential: D.M.D.
Phone: 302-475-1122