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General NPI Number Information
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NPI Number | 1962788802
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Entity Type | Organization
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Legal Business Name | SAMPSON DENTISTRY INC
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 1340 US HIGHWAY 42 NE
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City | LONDON
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State | OH
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Zip | 43140-8516
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Country | US
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Telephone | 614-879-9000
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Fax | 614-879-8679
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Provider Business Mailing Address
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Address Line | 1340 US HIGHWAY 42 NE
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City | LONDON
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State | OH
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Zip | 43140-8516
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Country | US
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Telephone | 614-879-9000
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Fax | 614-879-8679
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NICOLE COUSINO STANKEY
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Credential |
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Telephone | 614-879-9000
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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 | 30.019703
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License Number State | OH
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