Provider Demographics
NPI:1730876434
Name:SPRENGER, DACIA LYNN (CRDH)
Entity type:Individual
Prefix:
First Name:DACIA
Middle Name:LYNN
Last Name:SPRENGER
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FREELAND LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9205
Mailing Address - Country:US
Mailing Address - Phone:386-627-9333
Mailing Address - Fax:
Practice Address - Street 1:700 ANASTASIA BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-4616
Practice Address - Country:US
Practice Address - Phone:904-824-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH22776124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist