Individual
GLENN D SPRADLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5782
KY
1223P0221X
Pediatric Dentistry
Primary
5782
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60057825
—
KY
Enumeration date
08/17/2006
Last updated
04/06/2010
Update your record
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