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General NPI Number Information
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NPI Number | 1639502396
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Entity Type | Individual
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Provider Name | SPENCER FREDERICK HOLMES DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 3286 PENTAGON PARK BLVD
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City | BEAVERCREEK
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State | OH
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Zip | 45431
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Country | US
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Telephone | 423-802-1381
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Fax |
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Provider Business Mailing Address
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Address Line | 15 LONSDALE AVE
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City | OAKWOOD
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State | OH
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Zip | 45419-3143
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Country | US
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Telephone | 423-802-1381
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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 | 2901022535
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License Number State | MI
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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 | DL13207
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 29417
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.026809
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License Number State | OH
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