Individual
DR. SUMITA SUSAN SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1395 CENTER DR RM D8-6, GAINESVILLE, FL 32610-3006
(352) 273-6703
Mailing address
PO BOX 100414, GAINESVILLE, FL 32610-0414
(352) 273-6695
(352) 294-5310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
291022390
MI
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DTP805
FL
Other
Enumeration date
07/21/2017
Last updated
03/09/2024
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