Individual
GREGORY KEITH SPACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MBA
Contact information
Practice address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-3477
(210) 567-3493
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-3470
(210) 567-2995
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126780805
MEDICAL DENTAL
TX
05
—
126785803
—
TX
Enumeration date
07/28/2005
Last updated
01/28/2014
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