Provider Demographics
NPI:1932391059
Name:SAMS, VILMA (DDS)
Entity type:Individual
Prefix:MRS
First Name:VILMA
Middle Name:
Last Name:SAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5075 S BRADLEY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5077
Mailing Address - Country:US
Mailing Address - Phone:805-934-7705
Mailing Address - Fax:805-934-7707
Practice Address - Street 1:5075 S BRADLEY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5077
Practice Address - Country:US
Practice Address - Phone:805-934-7705
Practice Address - Fax:805-934-7707
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA512981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice