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Individual

MICHAEL C SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1836 BROADWAY ST, PADUCAH, KY 42001-2708
(270) 442-0256
(270) 442-8730
Mailing address
1836 BROADWAY ST, PADUCAH, KY 42001-2708
(270) 442-0256
(270) 442-8730

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9016
KY

Other

Enumeration date
06/14/2011
Last updated
11/12/2014
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