# SAMUEL DASTRUP DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902763840
- **Authorized official:** DR. SAMUEL DASTRUP DDS (OWNER/DENTIST)
- **Authorized official phone:** (801) 821-8982

## Contact information

- **Practice address:** 430 S SALISBURY AVE, SPENCER, NC 28159-2239
- **Practice address phone:** (704) 633-1260
- **Practice address fax:** (704) 633-1263
- **Mailing address:** PO BOX 113, SPENCER, NC 28159-0113
- **Mailing address phone:** (435) 671-8491
- **Mailing address fax:** (704) 633-1263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2026
- **Last updated:** 01/05/2026