Provider Demographics
NPI:1518032903
Name:SPENCE, JEFFREY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:SPENCE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 JOSHUA LN
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-6208
Mailing Address - Country:US
Mailing Address - Phone:434-589-6999
Mailing Address - Fax:434-589-9561
Practice Address - Street 1:40 JOSHUA LN
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-6208
Practice Address - Country:US
Practice Address - Phone:434-589-6999
Practice Address - Fax:434-589-9561
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010077811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice