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General NPI Number Information
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NPI Number | 1235381815
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Entity Type | Individual
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Provider Name | MAXIMUS SAM ZAND DMD
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Gender | Male
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 9776 BONITA BEACH RD SE STE 202A
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4775
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Country | US
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Telephone | 123-981-0082
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Fax | 232-931-9513
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Provider Business Mailing Address
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Address Line | 9776 BONITA BEACH RD SE STE 202A
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4775
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Country | US
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Telephone | 239-810-0821
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN19169
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License Number State | FL
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