Provider Demographics
NPI:1003066812
Name:DURAN, SAMUEL JR (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:DURAN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 DIXIELAND RD
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3351
Mailing Address - Country:US
Mailing Address - Phone:956-428-5322
Mailing Address - Fax:956-428-7986
Practice Address - Street 1:1214 DIXIELAND RD
Practice Address - Street 2:SUITE # 4
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3351
Practice Address - Country:US
Practice Address - Phone:956-428-5322
Practice Address - Fax:956-428-7986
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX242881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice