Provider Demographics
NPI:1861577082
Name:SPOONT, E. ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:E. ROBERT
Middle Name:
Last Name:SPOONT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21301 POWERLINE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2388
Mailing Address - Country:US
Mailing Address - Phone:561-482-8000
Mailing Address - Fax:561-488-2936
Practice Address - Street 1:21301 POWERLINE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2388
Practice Address - Country:US
Practice Address - Phone:561-482-8000
Practice Address - Fax:561-488-2936
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 89071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice