Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 018428 | GA |
NPI | 1023058948 |
---|---|
Provider Name | Dennis L Spangler |
First Address | Kennesaw, GA 30144-3715 |
Second Address | Atlanta, GA 30328-5334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 11/08/2010 |