Individual
DR. SAMUEL J. JASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
800 ROSE ST RM D104, UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY, LEXINGTON, KY 40536-0297
(859) 323-6193
Mailing address
800 ROSE ST RM D104, UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY, LEXINGTON, KY 40536-0297
(859) 323-6193
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5169
KY
1223P0300X
Periodontics
Primary
5169
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60051695
—
KY
Enumeration date
09/15/2006
Last updated
01/20/2015
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