Provider Demographics
| NPI: | 1053340109 |
|---|---|
| Name: | SPANGLER, LAMBERT AND LIPP, DDS, PLLC |
| Entity type: | Organization |
| Organization Name: | SPANGLER, LAMBERT AND LIPP, DDS, PLLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ADMINISTRATIVE ASSISTANT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | RUTH |
| Authorized Official - Middle Name: | ANN |
| Authorized Official - Last Name: | MCDOWELL DAUGHTRY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 336-768-1332 |
| Mailing Address - Street 1: | 1544 N PEACE HAVEN RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WINSTON SALEM |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27104-1328 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 336-768-1332 |
| Mailing Address - Fax: | 336-768-9470 |
| Practice Address - Street 1: | 1544 N PEACE HAVEN RD |
| Practice Address - Street 2: | |
| Practice Address - City: | WINSTON SALEM |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 27104-1328 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 336-768-1332 |
| Practice Address - Fax: | 336-768-9470 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-07-01 |
| Last Update Date: | 2024-10-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 1223P0221X | Dental Providers | Dentist | Pediatric Dentistry | Group - Single Specialty |