Individual
JESSICA COLLINS SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
216 WARDELL RD, PEMBROKE, NC 28372
(910) 521-8646
(910) 521-8643
Mailing address
216 WARDELL RD, PEMBROKE, NC 28372
(910) 521-8646
(910) 521-8643
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8208
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905480
—
NC
Enumeration date
04/12/2007
Last updated
07/09/2007
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