Provider Demographics
NPI:1104863653
Name:MARLEY-HARROD, SAMANTHA LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LEE
Last Name:MARLEY-HARROD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-4812
Mailing Address - Country:US
Mailing Address - Phone:405-842-4646
Mailing Address - Fax:405-840-5803
Practice Address - Street 1:6532 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-4812
Practice Address - Country:US
Practice Address - Phone:405-842-4646
Practice Address - Fax:405-840-5803
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK55521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice