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General NPI Number Information
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NPI Number | 1942435318
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Entity Type | Individual
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Provider Name | JONATHAN DAVID SPENN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 1801 SE 32 AVE
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City | OCALA
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State | FL
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Zip | 34471
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Country | US
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Telephone | 352-620-6868
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Fax | 352-620-6480
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Provider Business Mailing Address
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Address Line | 1501 W SILVER SPRINGS BLVD
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City | OCALA
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State | FL
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Zip | 34475
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Country | US
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Telephone | 352-622-2664
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Fax | 352-622-2363
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | DN21699
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.027785
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License Number State | IL
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