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General NPI Number Information
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NPI Number | 1952650731
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Entity Type | Individual
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Provider Name | MICHAEL T SPADAFORA DMD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 95 ALMSHOUSE RD SUITE 201
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City | RICHBORO
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State | PA
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Zip | 18954-1154
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Country | US
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Telephone | 215-364-2420
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Fax |
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Provider Business Mailing Address
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Address Line | 17 GABLEWING CIR
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City | NEWTOWN
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State | PA
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Zip | 18940-3316
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Country | US
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Telephone | 267-566-3081
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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 | 22 DI 02511200
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License Number State | NJ
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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 | DS 039154
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License Number State | PA
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