Provider Demographics
NPI:1023136462
Name:STRONG, SAMUEL M (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:M
Last Name:STRONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1415 BRECKENRIDGE DR
Mailing Address - Street 2:STE D
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227
Mailing Address - Country:US
Mailing Address - Phone:501-224-2333
Mailing Address - Fax:501-224-5230
Practice Address - Street 1:1415 BRECKENRIDGE DR
Practice Address - Street 2:STE D
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227
Practice Address - Country:US
Practice Address - Phone:501-224-2333
Practice Address - Fax:501-224-5230
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR21371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice