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General NPI Number Information
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NPI Number | 1982707519
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Entity Type | Individual
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Provider Name | DARYL LEROY SPECHT DDS
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 802 N DUSTIN AVE
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City | FARMINGTON
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State | NM
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Zip | 87401-6104
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Country | US
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Telephone | 505-327-3055
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Fax |
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Provider Business Mailing Address
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Address Line | 1078 COUNTY RD 3000
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City | FARMINGTON
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State | NM
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Zip | 87401-7944
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Country | US
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Telephone | 505-325-7127
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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 | 934
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License Number State | NM
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