DR. J. SPENCER BOLEY (NPI# 1962623819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962623819 |
| Entity Type | Individual |
| Full Name | DR. J. SPENCER BOLEY |
| Credential | D.M.D |
| Practice Address |
4501 W Wedge Dr Fayetteville AR 72704-7532 |
| Practice Telephone | 5024683170 |
| Mailing Telephone | 5024683170 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2010-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3784 | AR | Dental Providers |
| Street Address |
4501 W WEDGE DR |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72704-7532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387037 | Anne-ashley Hull | Speech-Language Pathologist | 12905 Randolph Road, Fayetteville, AR 72704 | 2020-05-07 |
| 1427607019 | Destiny Bound, LLC | Midwife | 3825 N Salem Road, Fayetteville, AR 72704 | 2019-09-06 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| 1104319433 | Rise Physical Therapy Pa | Clinic/Center | 3484 W Wedington Dr Ste 4, Fayetteville, AR 72704 | 2018-06-12 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1528410487 | Sharon Byrd | Licensed Practical Nurse | 17836 Harmon Rd, Fayetteville, AR 72704 | 2016-07-05 |
| 1861823502 | Andrea Warren | Pharmacist | 2875 W Martin Luther King Jr Blvd, Fayetteville, AR 72704 | 2013-12-05 |
| 1609157726 | Jessica Rose Collier | Speech-Language Pathologist | 2020 E Joyce Ave., Suite 2, Fayetteville, AR 72704 | 2011-09-02 |
| 1194044941 | Wcnc, Inc. | Skilled Nursing Facility | 4405 Persimmon Street, Fayetteville, AR 72704 | 2010-05-19 |
| 1841512944 | Jill K Johnston | Speech-Language Pathologist | 3472 N Sandpiper Dr, Fayetteville, AR 72704 | 2010-02-17 |
| Find all providers in zip 72704 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578001616 | Jesse R Gray Dds Pa | Dentist | 3119 E Mission Blvd, Fayetteville, AR 72703-6617 | 2017-02-09 |
| 1972972685 | Trinity Orthodontics of Fayetteville LLC | Dentist | 719 Lanier Ave W Ste B, Fayetteville, GA 30214-7621 | 2015-09-23 |
| 1386048189 | Bethel Burris Oliver Pllc | Dentist | 2901 Zion Rd, Fayetteville, AR 72703-5007 | 2014-10-22 |
| 1083957351 | Gateway Ventures LLC | Dentist | 3782 N Front St, Suite 1, Fayetteville, AR 72703-5128 | 2013-04-04 |
| 1780995449 | Gregory J Stock | Dentist | 404 E Genesee St, Fayetteville, NY 13066-1503 | 2010-06-28 |
| 1003019845 | Dana Thi Tang | Dentist | 2997 Hope Mills Rd Ste C, Fayetteville, NC 28306-8349 | 2007-06-08 |
| 1326256066 | Eric J. Echols | Dentist | 102 Pavilion Pkwy, Suite 14, Fayetteville, GA 30214-4056 | 2007-05-18 |
| 1033325436 | Darrin Storms D.d.s., C.a.g.s., P.a. | Dentist | 4102 N Mall Ave Ste 101, Fayetteville, AR 72703-4929 | 2007-05-15 |
| 1992864375 | Michael W Granger | Dentist | 745 Bradley Dr, Fayetteville, GA 30214-2030 | 2006-12-08 |
| 1922166610 | Bill Pickard, Dds, Ms, Pa | Dentist | 3533 N Shiloh Dr Ste 3, Fayetteville, AR 72703-5317 | 2006-12-05 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.