Individual
MARIO J SAMANIEGO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2569 E IDAHO AVE, SUITE A, LAS CRUCES, NM 88011-4578
(505) 523-1479
(505) 523-2974
Mailing address
2569 E IDAHO AVE, SUITE A, LAS CRUCES, NM 88011-4578
(505) 523-1479
(505) 523-2974
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1515
NM
Other
Enumeration date
04/26/2006
Last updated
07/08/2007
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