Healthcare Provider Details

I. General information

NPI: 1437087665
Provider Name (Legal Business Name): SAMUEL SHREWSBURY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1747 US HIGHWAY 1 S
ST AUGUSTINE FL
32084-4238
US

IV. Provider business mailing address

3001 W ROLLING HILLS CIR APT 504
DAVIE FL
33328-1917
US

V. Phone/Fax

Practice location:
  • Phone: 904-495-0881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: