MEDICARE: DR. SAM HENRY CONTINO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D25249	CA

General Provider Information

NPI Number	:	1396768800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM HENRY CONTINO DMD

Provider Business Mailing Address
First Line	:	3858 E COLORADO BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3940
Country	:	US
Telephone Number	:	626-795-4251
Fax Number	:

Provider Business Practice Location Address
First Line	:	3858 E COLORADO BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3940
Country	:	US
Telephone Number	:	626-795-4251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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