Bradlee Steven Spence, DDS
Individual provider Active NPI General Practice Dentistry · Fredericktown, OH
NPI 1992907570 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992907570
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 17950 (OH)
- Practice address
- 16400 Village Pkwy
Fredericktown, OH 43019-9585 - Phone
- (740) 694-1748
- Fax
- (740) 694-9672
- NPI assigned
- Jun 5, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17950 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17950 | OH | Yes |
Addresses
Primary practice location
16400 Village Pkwy
Fredericktown, OH 43019-9585
Mailing address
PO Box 122
Fredericktown, OH 43019-0122
Phone (740) 694-1748
Other providers in Fredericktown, OH
- Jessica Singrey
- Diane Linda Smith
- Matthew Bradley Smith
- Jerald Snelling
- Megan Snider
- Jeffrey Clark Spencer
- Heather Marie Staton
- Todd Brandon Stephens
- Craig Mason Stump
- Elyse Delane Swihart
All providers in Fredericktown, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.