Individual
JENNIFER SPIVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
506 W MARINE WAY, KODIAK, AK 99615-7318
(907) 486-3269
Mailing address
PO BOX 3494, KODIAK, AK 99615-3494
(907) 486-0939
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
922
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40281
—
AK
01
—
874078
UCCI
AK
Enumeration date
10/03/2006
Last updated
07/09/2007
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