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Organization
OLIVE DENTAL PLLC
Active
Organization
OLIVE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAER AL AZZAWI D.M.D. (GENERAL DENTIST/OWNER)
(713) 382-8654
Entity
Organization
Contact information
Practice address
9510 BEECHNUT ST, SUITE A1, HOUSTON, TX 77036-6608
(713) 382-8654
Mailing address
2119 WESTHEIMER RD, APT 1126, HOUSTON, TX 77098-1974
(713) 382-8654
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31017
TX
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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