Provider Demographics
NPI:1821574047
Name:WARD, SAMANTHA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:M
Last Name:WARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-5195
Mailing Address - Country:US
Mailing Address - Phone:401-762-2422
Mailing Address - Fax:401-767-2512
Practice Address - Street 1:460 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-5195
Practice Address - Country:US
Practice Address - Phone:401-762-2422
Practice Address - Fax:401-767-2512
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI033971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice