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General NPI Number Information
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NPI Number | 1669159257
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Entity Type | Organization
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Legal Business Name | DENTURECARE LLC
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1133 E MORRIS BLVD
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City | MORRISTOWN
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State | TN
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Zip | 37813-5902
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Country | US
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Telephone | 423-839-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 E MORRIS BLVD
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City | MORRISTOWN
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State | TN
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Zip | 37813-5902
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Country | US
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Telephone | 423-839-1221
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Fax |
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Authorized Official
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Title or Position | CLINIC DR
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Name | DR. SPENCER SHOFF
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Credential | DMD
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Telephone | 912-650-3035
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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 |
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License Number State |
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