Stephen Marvin Sampson, DDS

Individual provider Active NPI General Practice Dentistry · Westfield, PA

NPI 1104848415 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104848415
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS021305L (PA)
Practice address
108 E Main St
Westfield, PA 16950-1605
Phone
(814) 367-5501
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS021305LPAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS021305L PA Yes

Addresses

Primary practice location

108 E Main St
Westfield, PA 16950-1605

Mailing address

108 E Main St
Westfield, PA 16950-1605
Phone (814) 367-5501

Other providers in Westfield, PA

All providers in Westfield, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.