Individual
DR. SAM WILEY QUILLEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
HWY 317, 861 SUITE A BX 36, NEON, KY 41840-0036
(606) 855-7892
(606) 855-7892
Mailing address
PO BOX 36, 861 SUITE A, NEON, KY 41840-0036
(606) 855-7892
(606) 855-7892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4626
KY
Other
Enumeration date
12/06/2006
Last updated
12/13/2013
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