Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | CA 14181 | CA |
NPI | 1013011527 |
---|---|
Provider Name | Dr. Byron Reginald Spears JR. |
First Address | Pasadena, CA 91105 |
Second Address | Pasadena, CA 91105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |