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Organization
SPRUCE DENTAL
Active
Organization
SPRUCE DENTAL
Active
Other names
Advanced Implant Dentistry and Oral Restoration
Organization subpart
No
Provider details
NPI number
Authorized official
ALLON WALTUCH DDS (DENTIST)
(515) 295-3826
Entity
Organization
Contact information
Practice address
76 SPRUCE ST, CEDARHURST, NY 11516-2018
(515) 295-3826
Mailing address
76 SPRUCE ST, CEDARHURST, NY 11516-2018
(515) 295-3826
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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