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General NPI Number Information
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NPI Number | 1023469723
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Entity Type | Individual
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Provider Name | STACEY NYGAARD SPELLMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 2761 W 120TH AVE STE 220
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City | WESTMINSTER
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State | CO
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Zip | 80234-2980
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Country | US
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Telephone | 303-457-2266
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Fax | 303-457-0464
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Provider Business Mailing Address
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Address Line | 2761 W 120TH AVE STE 220
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City | WESTMINSTER
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State | CO
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Zip | 80234-2980
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Country | US
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Telephone | 303-457-2266
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Fax | 303-457-0464
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 203902
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License Number State | CO
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