Provider Demographics
NPI:1366469850
Name:SAMOST, DAVID S (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:SAMOST
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 1:58 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902
Mailing Address - Country:US
Mailing Address - Phone:781-599-2345
Mailing Address - Fax:781-599-2380
Practice Address - Street 1:58 BROAD ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902
Practice Address - Country:US
Practice Address - Phone:781-599-2345
Practice Address - Fax:781-599-2380
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA92631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice