Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DI020716 | NJ |
NPI | 1124191358 |
---|---|
Provider Name | Spencer Carl Saint-Cyr |
First Address | Moorestown, NJ 08057-3382 |
Second Address | Northfield, NJ 08225-1442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/03/2013 |