| NPI | 1356775613 |
|---|---|
| Professional Name | SHAWN SAMAD |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401414153) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15535) |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |