Provider Demographics
NPI:1649350463
Name:SPENCER, JACLYNN ZABEL (DDS)
Entity type:Individual
Prefix:DR
First Name:JACLYNN
Middle Name:ZABEL
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 W 112TH CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031
Mailing Address - Country:US
Mailing Address - Phone:303-641-4838
Mailing Address - Fax:
Practice Address - Street 1:30 S 20TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3705
Practice Address - Country:US
Practice Address - Phone:303-659-3062
Practice Address - Fax:303-659-5742
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice