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General NPI Number Information
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NPI Number | 1598576787
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Entity Type | Organization
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Legal Business Name | SAM COLEMAN DMD, PLLC
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1608B GILMER AVE
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City | TALLASSEE
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State | AL
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Zip | 36078-2314
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Country | US
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Telephone | 334-799-2634
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Fax |
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Provider Business Mailing Address
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Address Line | 1608B GILMER AVE
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City | TALLASSEE
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State | AL
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Zip | 36078-2314
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Country | US
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Telephone | 334-799-2634
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAM COLEMAN
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Credential | DMD
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Telephone | 334-300-2402
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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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