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Organization
SPIKA DENTAL, INC.
Active
Organization
SPIKA DENTAL, INC.
Active
Other names
McGovern and Borin Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD CHARLES SPIKA DMD (PRESIDENT)
(253) 651-0705
Entity
Organization
Contact information
Practice address
312 W LINE ST, BISHOP, CA 93514-3413
(253) 651-0705
Mailing address
PO BOX 2185, MAMMOTH LAKES, CA 93546-2185
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
102998
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578603627
NPI
CA
01
—
1841345444
NPI
CA
Enumeration date
08/09/2018
Last updated
08/09/2018
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