Individual
DR. STUART Z SAMPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
850 FAIRWAY CHADWICK PLAZA, CHILLICOTHE, MO 64601
(660) 646-3802
(660) 646-3887
Mailing address
850 FAIRWAY CHADWICK PLAZA, CHILLICOTHE, MO 64601
(660) 646-3802
(660) 646-3887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
015117
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35602016
BLUE CROSS BLUE SHIELD
—
05
—
407272202
—
MO
Enumeration date
09/27/2006
Last updated
05/10/2011
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