Organization
SAMUEL BARTLETT DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL BARTLETT (ORGANIZER/MEMBER)
(435) 553-5392
Entity
Organization
Contact information
Practice address
3309 HEALY DR STE B, WINSTON SALEM, NC 27103-1474
(366) 765-8847
Mailing address
3309 HEALY DR STE B, WINSTON SALEM, NC 27103-1474
(366) 765-8847
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821447350
—
NC
Enumeration date
09/21/2020
Last updated
09/21/2020
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