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NPI Code Detail

MEDICARE: DR. GEORGE JOOSEPH SPADER DDS

MEDICARE: DR. GEORGE JOOSEPH SPADER DDS
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
1122300000XDentist13955MI

General Provider Information

NPI Number : 1548218977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE JOOSEPH SPADER DDS
Provider Business Mailing Address
First Line : 7437 JACKMAN RD
Second Line :
City : TEMPERANCE
State : MI
Zip : 48182-9223
Country : US
Telephone Number : 734-847-1780
Fax Number : 734-847-2080
Provider Business Practice Location Address
First Line : 7437 JACKMAN RD
Second Line :
City : TEMPERANCE
State : MI
Zip : 48182-9223
Country : US
Telephone Number : 734-847-1780
Fax Number : 734-847-2080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 03/24/2015

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