Healthcare Provider Details

I. General information

NPI: 1659430080
Provider Name (Legal Business Name): RICHARD JAMES SPENCE DMD, PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 SOUTH ST
CLAREMONT NH
03743-3180
US

IV. Provider business mailing address

51 KAARTINE RD
SPRINGFIELD VT
05156-9236
US

V. Phone/Fax

Practice location:
  • Phone: 603-543-0455
  • Fax: 603-543-3936
Mailing address:
  • Phone: 802-885-5251
  • Fax: 603-543-3936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number1507
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: