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General NPI Number Information
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NPI Number | 1063046308
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Entity Type | Organization
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Legal Business Name | GEORGE J. SPADER, DDS, PC
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 7437 JACKMAN RD
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City | TEMPERANCE
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State | MI
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Zip | 48182-9223
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Country | US
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Telephone | 734-847-1780
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Fax | 734-847-2080
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Provider Business Mailing Address
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Address Line | 7437 JACKMAN RD
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City | TEMPERANCE
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State | MI
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Zip | 48182-9223
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Country | US
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Telephone | 734-847-1780
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Fax | 734-847-2080
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE JOSEPH SPADER
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Credential | DDS
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Telephone | 734-847-1780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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