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General NPI Number Information
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NPI Number | 1568793990
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Entity Type | Organization
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Legal Business Name | JOHN SPERO D.M.D., LLC
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 1060 US ROUTE 1
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City | YORK
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State | ME
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Zip | 03909-5821
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Country | US
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Telephone | 207-363-2406
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Fax | 207-363-6037
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Provider Business Mailing Address
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Address Line | PO BOX 323
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City | YORK
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State | ME
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Zip | 03909-0323
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Country | US
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Telephone | 207-363-2406
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Fax | 207-363-6037
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN M. SPERO
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Credential | D.M.D., F.A.G.D
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Telephone | 207-363-2406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3569
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License Number State | ME
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