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General NPI Number Information
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NPI Number | 1093976383
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Entity Type | Individual
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Provider Name | WILLIAM ROBERT SAMSON DDS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 3997 VALLEY COMMONS DRIVE SUITE A
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City | BOZEMAN
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State | MT
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Zip | 59718-4108
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Country | US
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Telephone | 406-404-1186
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Fax | 406-404-1187
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Provider Business Mailing Address
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Address Line | 3997 VALLEY COMMONS DRIVE SUITE A
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City | BOZEMAN
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State | MT
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Zip | 59718
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Country | US
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Telephone | 406-404-1186
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Fax | 406-404-1187
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | R418
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2349
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License Number State | MT
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