Provider Demographics
NPI:1770574089
Name:SAMOYLOVICH, ESFIR (DDS)
Entity type:Individual
Prefix:DR
First Name:ESFIR
Middle Name:
Last Name:SAMOYLOVICH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 HWY 516
Mailing Address - Street 2:STE C
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:05857
Mailing Address - Country:US
Mailing Address - Phone:732-607-9005
Mailing Address - Fax:732-607-9006
Practice Address - Street 1:2433 HWY 516
Practice Address - Street 2:STE C ALABRAMI DENTAL CARE
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:05857
Practice Address - Country:US
Practice Address - Phone:732-607-9005
Practice Address - Fax:732-607-9006
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI19036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7505205Medicaid