James L Samples DDS ,PC

Organization Active NPI General Practice Dentistry · Carrollton, MO

NPI 1104987841 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1104987841
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
11650 (MO)
Legal business name
JAMES L SAMPLES DDS ,PC
Practice address
1411A N Jefferson St
Carrollton, MO 64633-1945
Phone
(660) 542-1653
NPI assigned
Dec 13, 2006
Organization subpart
No

Authorized official

Name
Dr. James Lee Samples, DDS
Title
Owner
Phone
(660) 542-1653

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 11650 MO Yes

Addresses

Primary practice location

1411A N Jefferson St
Carrollton, MO 64633-1945

Mailing address

122 Walnut Dr
Carrollton, MO 64633-1376
Phone (660) 542-2512

Other identifiers

IdentifierTypeStateIssuer
BCBSKC #05646 01 4OtherMOINSURANCE

Other providers in Carrollton, MO

All providers in Carrollton, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.