Provider Demographics
NPI:1871622027
Name:BRUCE T. SPINK, D.M.D., P.C.
Entity type:Organization
Organization Name:BRUCE T. SPINK, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:SPINK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-967-8555
Mailing Address - Street 1:4005 CROSSHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5229
Mailing Address - Country:US
Mailing Address - Phone:205-967-8555
Mailing Address - Fax:205-968-0202
Practice Address - Street 1:4005 CROSSHAVEN DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-5229
Practice Address - Country:US
Practice Address - Phone:205-967-8555
Practice Address - Fax:205-968-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty