Samuelson, Allen Douglas
Samuelson, Allen Douglas is an individual health care provider with primary practice located at Cb # 7450 101 Brauer Hall , Chapel Hill NC 27599-0001. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / General Practice is his primary health care specialty. Samuelson, Allen Douglas can be contacted via phone (919) 966-1221.Contact Information
Primary practice address
Cb # 7450 101 Brauer Hall
Chapel Hill NC 27599-0001
Phone: (919) 966-1221
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6174 | North Carolina |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 6174 | North Carolina |
Profile Details
| NPI number | 1750463345 |
|---|---|
| LBN Legal business name | Samuelson, Allen Douglas |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Aug 31st, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750463345 | NPPES |
| Other | 91934 | BCBS | |
| MEDICAID | 8997572 | BCBS |
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