# DJ AND AK SPENCER DMD PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spencer Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336524594
- **Authorized official:** DR. ANNA K SPENCER DMD (DENTIST)
- **Authorized official phone:** (253) 279-1877

## Contact information

- **Practice address:** 22205 MERIDIAN AVE E, SUITE 109, GRAHAM, WA 98338
- **Practice address phone:** (253) 875-6599
- **Mailing address:** 22205 MERIDIAN AVE E, SUITE 109, GRAHAM, WA 98338
- **Mailing address phone:** (253) 875-6599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00010963 | WA | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 07/29/2015
- **Last updated:** 07/29/2015