Individual
SAMUEL SCROGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3580 KEAGY RD SW, ROANOKE, VA 24018-1152
(540) 989-5257
(540) 989-5259
Mailing address
3580 KEAGY RD SW, ROANOKE, VA 24018-1152
(540) 989-5257
(540) 989-5259
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401413811
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009911387
—
AL
05
—
009932141
—
AL
01
—
510-06443
BLUE CROSS BLUE SHIELD
AL
01
—
51529738
BLUE CROSS#-EASTERN DENTA
AL
Enumeration date
10/10/2006
Last updated
12/30/2024
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