Provider Demographics
NPI:1760046536
Name:TOVER, SAM HUNTER
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:HUNTER
Last Name:TOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6122 N STATE ROAD 7 APT 202
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3616
Mailing Address - Country:US
Mailing Address - Phone:561-251-8331
Mailing Address - Fax:
Practice Address - Street 1:333 NW 70TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2358
Practice Address - Country:US
Practice Address - Phone:954-472-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-27
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN244521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry