Individual
SPENCER WILLIAM TIPPETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
348 OAK ST, CENTRAL POINT, OR 97502-2241
(541) 664-2210
Mailing address
348 OAK ST, CENTRAL POINT, OR 97502-2241
(541) 664-2210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12196797-9923
UT
122300000X
Dentist
Primary
D11574
OR
122300000X
Dentist
D5263
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2020
Last updated
02/24/2022
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