MEDICARE: DR. JAY HAROLD SPIEGEL D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		AZ

General Provider Information

NPI Number	:	1316136047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY HAROLD SPIEGEL D.D.S

Provider Business Mailing Address
First Line	:	4235 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5343
Country	:	US
Telephone Number	:	602-843-2518
Fax Number	:	602-843-2303

Provider Business Practice Location Address
First Line	:	4235 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5343
Country	:	US
Telephone Number	:	602-843-2518
Fax Number	:	602-843-2303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	10/18/2007

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