Individual
SAMANTHA NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356
Mailing address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12480
TN
Other
Enumeration date
04/24/2024
Last updated
02/22/2026
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