Healthcare Provider Details

I. General information

NPI: 1821199019
Provider Name (Legal Business Name): SAM J EULER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 LINCOLN AVE
EVANSVILLE IN
47714-1727
US

IV. Provider business mailing address

8600 UNIVERSITY BLVD
EVANSVILLE IN
47712-3534
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-2122
  • Fax: 812-477-4773
Mailing address:
  • Phone: 812-464-1706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12007339
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: