Provider Demographics
NPI:1205406352
Name:SAMIA, PAUL ARTHUS JR
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ARTHUS
Last Name:SAMIA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 CAPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6609
Mailing Address - Country:US
Mailing Address - Phone:984-235-0047
Mailing Address - Fax:
Practice Address - Street 1:13700 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6609
Practice Address - Country:US
Practice Address - Phone:984-235-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12336122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist