Provider Demographics
NPI:1255772075
Name:SAMS, BILLY D II (DDS)
Entity type:Individual
Prefix:DR
First Name:BILLY
Middle Name:D
Last Name:SAMS
Suffix:II
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 1:9411 CYPRESS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4911
Mailing Address - Country:US
Mailing Address - Phone:239-248-0252
Mailing Address - Fax:239-248-3170
Practice Address - Street 1:9411 CYPRESS LAKE DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4911
Practice Address - Country:US
Practice Address - Phone:239-248-0252
Practice Address - Fax:239-248-3170
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20124122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist