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General NPI Number Information
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NPI Number | 1588328793
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Entity Type | Individual
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Provider Name | BRIAN SAMPAYO DMD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 2265 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1114
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Country | US
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Telephone | 813-537-8929
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Fax | 954-427-2436
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Provider Business Mailing Address
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Address Line | 2265 W HILLSBORO BLVD STE C
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1114
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Country | US
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Telephone | 786-486-4088
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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 | DN26493
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License Number State | FL
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