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General NPI Number Information
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NPI Number | 1790590248
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Entity Type | Organization
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Legal Business Name | NICHOLAS A SAMPALIS, DMD, PLLC.
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 158 E BRIDGE ST
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City | HOTCHKISS
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State | CO
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Zip | 81419-8141
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Country | US
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Telephone | 970-872-2299
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | HOTCHKISS
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State | CO
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Zip | 81419-0007
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Country | US
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Telephone | 208-929-5059
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. NICHOLAS SAMPALIS
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Credential | DMD
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Telephone | 970-872-2299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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