Individual
DR. ALLEN DOUGLAS SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
CB # 7450 101 BRAUER HALL, CHAPEL HILL, NC 27599-0001
(919) 966-1221
Mailing address
101 MANNING DRIVE, CB 7450, CHAPEL HILL, NC 27514-4220
(919) 537-3866
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6174
NC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6174
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8997572
—
NC
01
—
91934
BCBS
—
Enumeration date
10/20/2006
Last updated
08/31/2015
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