Provider Demographics
NPI:1265412399
Name:WEST, SAMUEL ARTHUR (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ARTHUR
Last Name:WEST
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 1:2063 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3127
Mailing Address - Country:US
Mailing Address - Phone:925-210-1125
Mailing Address - Fax:
Practice Address - Street 1:2063 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3127
Practice Address - Country:US
Practice Address - Phone:925-210-1125
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice