# MRS. ELIZABETH A. SAMBOL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1790768018
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5353 | NE | Yes |

## Other

- **Enumeration date:** 11/21/2005
- **Last updated:** 01/19/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5647 | BLUECROSS BLUESHIELD | NE |
| 01 | — | 709166 | UNITED CONCORDIA PPO | NE |