Provider Demographics
NPI:1306978234
Name:SAMAR DENTAL, INC
Entity type:Organization
Organization Name:SAMAR DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:OSPINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-885-5390
Mailing Address - Street 1:9860 NW 49TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1921
Mailing Address - Country:US
Mailing Address - Phone:305-885-5390
Mailing Address - Fax:
Practice Address - Street 1:747 E 9TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4553
Practice Address - Country:US
Practice Address - Phone:305-885-5390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN174931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty