Individual
EVANGELYN ALETHEIA SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1115 AZALEA PL, BREWTON, AL 36426-1318
(251) 867-8020
(251) 867-8079
Mailing address
1303 DR MARTIN L KING JR AVE, MOBILE, AL 36603-5341
(251) 432-4117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D0006178
AL
1223G0001X
General Practice Dentistry
D0006178
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173506
—
AL
Enumeration date
05/07/2014
Last updated
03/08/2018
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