Individual
DR. JADA JOHNSON SPELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
25882 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48336-1292
(888) 833-8441
(888) 330-4331
Mailing address
1315 E 52ND ST, CHICAGO, IL 60615-4049
(773) 363-5654
(773) 363-5654
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-023542
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103180
—
IL
Enumeration date
07/27/2006
Last updated
07/08/2007
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