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General NPI Number Information
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NPI Number | 1487012209
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Entity Type | Individual
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Provider Name | ALEXANDER SAMUEL DMD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 03/07/2018
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Provider Practice Location Address
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Address Line | 2637 HOFFMAN DR
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City | ORLANDO
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State | FL
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Zip | 32837-7444
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Country | US
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Telephone | 407-496-6495
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Fax |
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Provider Business Mailing Address
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Address Line | 150 55TH ST STATION 20
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City | BROOKLYN
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State | NY
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Zip | 11220-2508
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN21357
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License Number State | FL
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