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Individual
DR. SAM R POLLOCK
Active
Individual
DR. SAM R POLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2051
MT
1223G0001X
General Practice Dentistry
Primary
2051
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120105
—
MT
01
—
20514
BLUECROSS
MT
01
—
5512369
CHIP
MT
Enumeration date
10/04/2006
Last updated
11/01/2017
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