GREGORY KEITH SPACKMAN DDS MBA NPI 1790785061

NPI Information

Gregory Keith Spackman, DDS MBA is an oral and maxillofacial surgery dentist in San Antonio, TX. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Gregory Keith Spackman, DDS MBA NPI is 1790785061. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7703 FLOYD CURL DR
SAN ANTONIO, TX
ZIP 78229-901
Phone: (210) 567-3477
Fax: (210) 567-3493

The NPI 1790785061 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/28/2005 and was last updated on 1/28/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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