Individual
MICHELLE NICOLE SAMFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
BLDG 2441 21ST STREET, US ARMY DENTAL ACTIVITY, FORT CAMPBELL, KY 42240-1251
(270) 798-8977
(270) 956-0266
Mailing address
BLDG 2441 21ST STREET, US ARMY DENTAL ACTIVITY, FORT CAMPBELL, KY 42240-1251
(270) 798-8977
(270) 956-0266
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3575
KY
Other
Enumeration date
07/03/2007
Last updated
06/15/2016
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