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Individual

DR. IVAN MARK SAMANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
50 W BIG BEAVER, STE 100 A, BLOOMFIELD HILLS, MI 48304
(248) 290-2900
(248) 290-2904
Mailing address
50 W BIG BEAVER, STE 100 A, BLOOMFIELD HILLS, MI 48304
(248) 290-2900
(248) 290-2904

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18371
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0183710
BCBS
MI
01
1811510
UNITED CONCORDIA
05
4852555
MI
Enumeration date
10/06/2006
Last updated
07/08/2007
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