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Individual

BLAKE TYLER SAMPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5540 SUNSET BLVD, LEXINGTON, SC 29072-9262
(803) 358-8250
Mailing address
11815 VANCE JACKSON RD APT 2401, SAN ANTONIO, TX 78230-1445
(205) 746-7318

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.10806
SC

Other

Enumeration date
03/06/2024
Last updated
06/05/2024
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