Individual
DR. TERRY MICHAEL SPENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2103 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4401
(573) 332-7223
(573) 334-7379
Mailing address
2103 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4401
(573) 332-7223
(573) 334-7379
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
015924
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-1535914
TAX ID #
MO
Enumeration date
02/16/2010
Last updated
07/05/2011
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