Organization
JAMES L SAMPLES DDS ,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LEE SAMPLES DDS (OWNER)
(660) 542-1653
Entity
Organization
Contact information
Practice address
1411A N JEFFERSON ST, CARROLLTON, MO 64633-1945
(660) 542-1653
Mailing address
122 WALNUT DR, CARROLLTON, MO 64633-1376
(660) 542-2512
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11650
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBSKC #05646 01 4
INSURANCE
MO
Enumeration date
12/13/2006
Last updated
08/22/2020
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