Provider Demographics
NPI:1881925139
Name:SAMANO, ROLANDO
Entity type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:SAMANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 E. MADISON ST.
Mailing Address - Street 2:SUITE #201
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-465-4231
Mailing Address - Fax:956-465-4228
Practice Address - Street 1:CALLE PRIMERA #267
Practice Address - Street 2:ENTRE NARDOS Y ROSAS. COL. JARDIN
Practice Address - City:H. MARAMOROS
Practice Address - State:TAMAULIPAS
Practice Address - Zip Code:87330
Practice Address - Country:MX
Practice Address - Phone:956-465-4231
Practice Address - Fax:956-465-4228
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ0017335411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice