Individual provider · Type 1 NPI

Samuel Tack

Oral and Maxillofacial Surgery (Dentist) · Richmond, VA

NPI number 1033658406 Active

Practice location

520 N 12th St
Richmond, VA 23298-5064

Call (804) 628-7146 Map

Other practice locations

  • 27005 76th Ave, New Hyde Park, NY 11040-1402 · (718) 470-7000

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000X0401415733 (VA)
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X0438000489 (VA)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

106 other providers at this address

Other oral and maxillofacial surgery (dentist) providers in Richmond

See all in Richmond →

About NPI 1033658406

Samuel Tack's National Provider Identifier is 1033658406, issued on Feb 18, 2017. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Richmond, VA. The record was last updated on Sep 11, 2023.