Provider Demographics
NPI:1962785378
Name:PICK, SAMUEL E (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:E
Last Name:PICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 E FLAMINGO RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5269
Mailing Address - Country:US
Mailing Address - Phone:702-732-3754
Mailing Address - Fax:
Practice Address - Street 1:2840 E FLAMINGO RD
Practice Address - Street 2:SUITE G
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5269
Practice Address - Country:US
Practice Address - Phone:702-732-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist