Individual
SAMUEL N ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
8305 FALLS OF NEUSE RD STE 105, RALEIGH, NC 27615-3546
(919) 841-1720
(919) 841-1725
Mailing address
8305 FALLS OF NEUSE RD STE 105, RALEIGH, NC 27615-3546
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11509
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DL-11243
MA
Other
Enumeration date
06/23/2011
Last updated
06/26/2019
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