Individual
SPENCER CURTIS BEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4323 HILL ST, COLUMBIA, SC 29207-6022
(803) 751-4512
Mailing address
4115 S COLT HAVEN CIR, SALT LAKE CITY, UT 84124-2655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10380211-9922
UT
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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