| James L Samples Dds ,pc | |
|
1411a N Jefferson St Carrollton MO 64633-1945 | |
| (660) 542-1653 | |
| Not Available |
| Full Name | James L Samples Dds ,pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1411a N Jefferson St, Carrollton, Missouri |
| Authorized Official Name and Position | James Lee Samples (OWNER) |
| Authorized Official Contact | 6605421653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James L Samples Dds ,pc 122 Walnut Dr Carrollton MO 64633-1376 Ph: (660) 542-2512 | James L Samples Dds ,pc 1411a N Jefferson St Carrollton MO 64633-1945 Ph: (660) 542-1653 |
| NPI Number | 1104987841 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104987841 | NPI | - | NPPES |
| BCBSKC #05646 01 4 | Other | MO | INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11650 (Missouri) | Primary |
Hcc Contract Physician Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1411a N Jefferson St, Carrollton, MO 64633 Phone: 660-259-0224 | |
Carrollton Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1411a N Jefferson St, Carrollton, MO 64633 Phone: 660-542-1653 Fax: 660-542-1654 |