Individual
SAMUEL WADDOUPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
29955 TECHNOLOGY DR STE C112, MURRIETA, CA 92563-2637
(951) 445-4223
(951) 445-4095
Mailing address
29955 TECHNOLOGY DR STE C112, MURRIETA, CA 92563-2637
(951) 445-4223
(951) 445-4095
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
61987
CA
Other
Enumeration date
10/27/2012
Last updated
02/06/2013
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