Individual
SAMUEL TITUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(317) 753-5282
Mailing address
15520 BETHESDA CIR, WESTFIELD, IN 46074-8876
(317) 753-5282
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
R675
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12012699A
IN
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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