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Individual
SAMPETER LIECH ODERA
Active
Individual
SAMPETER LIECH ODERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN1856460
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A127360
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
OMS106
CA
Other
Enumeration date
04/24/2012
Last updated
05/05/2022
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