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General NPI Number Information
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NPI Number | 1093049207
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Entity Type | Individual
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Provider Name | SAMUEL JOSEPH INFANTINO DDS
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Gender | Male
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 10363 TORRE AVE STE F
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City | CUPERTINO
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State | CA
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Zip | 95014-3236
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Country | US
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Telephone | 408-252-8156
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Fax | 408-252-8192
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Provider Business Mailing Address
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Address Line | 10363 TORRE AVE STE F
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City | CUPERTINO
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State | CA
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Zip | 95014-3236
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Country | US
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Telephone | 408-252-8156
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Fax | 408-252-8192
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 58593
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License Number State | CA
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