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Individual
SPENCER ROARK
Active
Individual
SPENCER ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.033438
IL
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
12728
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12728
TN
Other
Enumeration date
03/23/2021
Last updated
01/30/2026
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