Provider Demographics
NPI:1023271921
Name:SPENCER, LORAY DANIELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:LORAY
Middle Name:DANIELLE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1658 CRANIUM DR
Mailing Address - Street 2:STE 106
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3585
Mailing Address - Country:US
Mailing Address - Phone:803-348-1732
Mailing Address - Fax:
Practice Address - Street 1:1035 14TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-3050
Practice Address - Country:US
Practice Address - Phone:803-348-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice