Provider Demographics
NPI:1033294970
Name:SAMS, ALVIN RAYE (DDS)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:RAYE
Last Name:SAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4145 N US HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2825
Mailing Address - Country:US
Mailing Address - Phone:314-355-9600
Mailing Address - Fax:314-355-9604
Practice Address - Street 1:4145 N US HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2825
Practice Address - Country:US
Practice Address - Phone:314-355-9600
Practice Address - Fax:314-355-9604
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO0149831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry