Provider Demographics
NPI:1790883841
Name:MELINE, SAMUEL M (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:M
Last Name:MELINE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:89 JUNIPER RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2817
Mailing Address - Country:US
Mailing Address - Phone:954-962-3939
Mailing Address - Fax:954-961-0521
Practice Address - Street 1:3146 NORTHSIDE DR # B
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-8014
Practice Address - Country:US
Practice Address - Phone:305-294-4661
Practice Address - Fax:305-294-4661
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL00025801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics