Provider Demographics
NPI:1669682266
Name:SAMARKOS, JOHN ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:SAMARKOS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 NW 75TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-1685
Mailing Address - Country:US
Mailing Address - Phone:352-331-4558
Mailing Address - Fax:352-331-4838
Practice Address - Street 1:105 NW 75TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-1685
Practice Address - Country:US
Practice Address - Phone:352-331-4558
Practice Address - Fax:352-331-4838
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist