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DR. SAM JOSEPH POIDMORE D,D,S,

Oral and Maxillofacial Surgery >> Dentist >> Dental Providers

Registrant NPI Number: 1316088529

Individual Registrant:
DR. SAM JOSEPH POIDMORE D,D,S,
Gender: M
Sole Proprietor

Location and contact information for practice:
18152 PAMELA PL  VILLA PARK, CA 92861-2626 US
Tel: 714-921-9662  Fax: 714-921-9667

Contact information for business:
18152 PAMELA PL  VILLA PARK, CA 92861-2626 US
Tel: 714-921-9662  Fax: 714-921-9667

Registration Information:
NPI: 1316088529
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223S0112XDental Providers
Dentist
Oral and Maxillofacial Surgery
CAD-24327

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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