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Individual

SPENCER LANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
301 N 1ST ST, ALTUS, OK 73523-5004
(720) 684-7688
Mailing address
301 N 1ST ST, ALTUS, OK 73523-5004
(720) 684-7688

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00205583
CO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/08/2023
Last updated
09/24/2024
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