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Organization

LEW B. SAMPLE, DMD, MS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LLEWELLYN BAIN SAMPLE DMD (PRESIDENT)
(256) 355-5255
Entity
Organization

Contact information

Practice address
2014 DANVILLE PARK DR SW, DECATUR, AL 35603-1832
(256) 355-5255
(256) 355-8183
Mailing address
2014 DANVILLE PARK DR SW, DECATUR, AL 35603-1832
(256) 355-5255
(256) 355-8183

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/15/2021
Last updated
09/15/2021
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