Provider Demographics
NPI:1982158952
Name:KING, SAMUEL ADAMS (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ADAMS
Last Name:KING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W CASCADE WAY
Mailing Address - Street 2:SUITE #201
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6016
Mailing Address - Country:US
Mailing Address - Phone:509-466-2499
Mailing Address - Fax:
Practice Address - Street 1:8814 S HANGMAN VALLEY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-8405
Practice Address - Country:US
Practice Address - Phone:509-951-5923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60676287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist