Provider Demographics
NPI:1669607016
Name:LESTER, SAMUEL REID (DMD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:REID
Last Name:LESTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095-3250
Mailing Address - Country:US
Mailing Address - Phone:662-834-9899
Mailing Address - Fax:
Practice Address - Street 1:102 CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-3250
Practice Address - Country:US
Practice Address - Phone:662-834-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3494-09122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist