| Full Name | Chad D Spiva |
|---|---|
| Speciality | Dentist |
| Location | 808 Ne 19th St, Moore, Oklahoma |
| Authorized Official Name and Position | Chad D Spiva (OWNER) |
| Authorized Official Contact | 4057995529 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chad D Spiva 808 Ne 19th St Moore OK 73160-6302 Ph: (405) 799-5529 | Chad D Spiva 808 Ne 19th St Moore OK 73160-6302 Ph: (405) 799-5529 |
| NPI Number | 1306011093 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306011093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5497 (Oklahoma) | Primary |
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› Verified 7 days ago
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