Healthcare Provider Details

I. General information

NPI: 1306576780
Provider Name (Legal Business Name): SPENCER DYRENG RICHARDS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 W SUNSET BLVD STE 15
SAINT GEORGE UT
84770-4849
US

IV. Provider business mailing address

929 W SUNSET BLVD STE 15
SAINT GEORGE UT
84770-4849
US

V. Phone/Fax

Practice location:
  • Phone: 435-656-5900
  • Fax:
Mailing address:
  • Phone: 435-656-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12855796-9923
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: