Provider Demographics
NPI:1801819230
Name:CIGNO, SAM E (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:E
Last Name:CIGNO
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 1:12000 BELLEFONTAINE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1903
Mailing Address - Country:US
Mailing Address - Phone:314-741-5133
Mailing Address - Fax:314-741-3161
Practice Address - Street 1:12000 BELLEFONTAINE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1903
Practice Address - Country:US
Practice Address - Phone:314-741-5133
Practice Address - Fax:314-741-3161
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice