| Organization Name: | CHARLES SAMMONS, DDS, PLLC |
| NPI Number: | 1376712471 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES SAMMONS (DENTIST) |
| Mailing Address: | 202 Water Street Louisa |
| State: | KY US |
| Postal Code: | 41230 |
| Phone Number: | 6066383400 |
| Fax Number: | 6066383410 |
| NPI Enumeration Date: | 02/22/2008 |
| NPI Last Update Date: | 02/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 6092 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |