Individual
DR. MICHAEL EUGUNE SPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
255 MAPLE AVE, VICTOR, NY 14564-1319
(585) 924-0580
Mailing address
255 MAPLE AVE, VICTOR, NY 14564-1319
(585) 924-0580
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
043443
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01346469
—
NY
Enumeration date
08/23/2006
Last updated
07/08/2007
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