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General NPI Number Information
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NPI Number | 1588262653
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Entity Type | Individual
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Provider Name | JEANNE SPENCE DDS
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Gender | Female
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 50 ANNA LOUISE LN
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City | ROANOKE RAPIDS
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State | NC
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Zip | 27870-8648
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Country | US
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Telephone | 252-537-5769
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Fax |
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Provider Business Mailing Address
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Address Line | 9001 PATTERSON AVE APT 131
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City | HENRICO
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State | VA
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Zip | 23229-6120
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Country | US
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Telephone |
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Fax |
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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 | 0401417017
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12268
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License Number State | NC
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