| Organization Name: | BRIAN W SPENDLOVE DDS PC |
| NPI Number: | 1255407011 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN WARD SPENDLOVE (PRESIDENT) |
| Mailing Address: | 753 W Highway 40 Vernal |
| State: | UT US |
| Postal Code: | 840782427 |
| Phone Number: | 4357893312 |
| Fax Number: | |
| NPI Enumeration Date: | 11/25/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 139801-9922 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |