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General NPI Number Information
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NPI Number | 1922598275
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Entity Type | Organization
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Legal Business Name | JULIE C. SPIVEY, D.M.D., P.L.L.C.
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Dates
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Enumeration Date | 05/12/2018
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Last Update Date | 05/12/2018
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Provider Practice Location Address
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Address Line | 407 N NC 16 BUSINESS HWY
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City | DENVER
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State | NC
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Zip | 28037-6003
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Country | US
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Telephone | 205-540-6928
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 WILMORE DR
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City | CHARLOTTE
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State | NC
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Zip | 28203-4343
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Country | US
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Telephone | 205-540-6928
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. JULIE C. SPIVEY
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Credential | DMD
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Telephone | 205-540-6928
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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 | 10515
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License Number State | NC
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