Wise, Sam

Wise, Sam is an sole proprietor health care provider with primary practice located at 3045 N Goliad St Ste 105 , Rockwall TX 75087-7097. He recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Dentist is his primary health care specialty. Wise, Sam can be contacted via phone (972) 722-9100.

Contact Information

Primary practice address
3045 N Goliad St Ste 105 Rockwall TX 75087-7097
Phone: (972) 722-9100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 35081 Texas
Dental Providers / General Practice 1223G0001X 60795714 Washington
Dental Providers / General Practice 1223G0001X 35081 Texas
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 35081 Texas

Profile Details

NPI number 1417416728
LBN Legal business name Wise, Sam
Credentials DDS, MOM, MSC, MDS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 16th, 2019
Last updated Jan 9th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417416728 NPPES
Texas Other 1487398285 NPI II
Texas Other 1518520170 NPI II

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