Provider Demographics
NPI:1629269923
Name:WALTZER, SAMAN M (DMD)
Entity Type:Individual
Prefix:
First Name:SAMAN
Middle Name:M
Last Name:WALTZER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SAMAN
Other - Middle Name:M
Other - Last Name:FREEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:1333 3RD AVE S STE 401
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6535
Mailing Address - Country:US
Mailing Address - Phone:239-238-1176
Mailing Address - Fax:239-238-1179
Practice Address - Street 1:1333 3RD AVE S STE 401
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6535
Practice Address - Country:US
Practice Address - Phone:239-238-1176
Practice Address - Fax:239-238-1179
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL179061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice