Individual
DR. ANTHONY TYLER SPATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 S LOOP 336 W STE 1000, CONROE, TX 77304-3362
(936) 270-1294
Mailing address
52 MOSS BRANCH CV, JACKSON, TN 38305-7580
(731) 571-3860
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2020023398
MO
122300000X
Dentist
Primary
39309
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2020023398
MO
Other
Enumeration date
07/27/2020
Last updated
03/12/2023
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