Provider Demographics
NPI:1730846874
Name:JULIE R. SAMS, DMD, LLC
Entity type:Organization
Organization Name:JULIE R. SAMS, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-375-2590
Mailing Address - Street 1:PO BOX 994
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36702-0994
Mailing Address - Country:US
Mailing Address - Phone:334-872-6277
Mailing Address - Fax:334-872-6701
Practice Address - Street 1:724 ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-4622
Practice Address - Country:US
Practice Address - Phone:334-872-6277
Practice Address - Fax:334-872-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental