Samano, Ivan Mark
Samano, Ivan Mark is an individual health care provider with primary practice located at 50 W Big Beaver Ste 100 A, Bloomfield Hills MI 48304. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Samano, Ivan Mark can be contacted via phone (248) 290-2900.Contact Information
Primary practice address
50 W Big Beaver Ste 100 A
Bloomfield Hills MI 48304
Phone: (248) 290-2900
Fax: (248) 290-2904
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 18371 | Michigan |
Profile Details
| NPI number | 1659468361 |
|---|---|
| LBN Legal business name | Samano, Ivan Mark |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659468361 | NPPES |
| Other | 1811510 | UNITED CONCORDIA | |
| Other | 0183710 | UNITED CONCORDIA | |
| MEDICAID | 4852555 | UNITED CONCORDIA |
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