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General NPI Number Information
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NPI Number | 1346007705
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Entity Type | Organization
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Legal Business Name | SAMANTHA AIEZZA DMD PLLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 3421 GRAYSTONE PL SE
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City | CONOVER
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State | NC
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Zip | 28613-8200
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Country | US
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Telephone | 828-328-3418
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Fax |
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Provider Business Mailing Address
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Address Line | 620 32ND AVENUE DR NW
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City | HICKORY
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State | NC
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Zip | 28601-9000
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Country | US
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Telephone | 941-737-5440
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. SAMANTHA AIEZZA
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Credential | DMD
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Telephone | 941-737-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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