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Organization
OLIVE FAMILY DENTAL LLC
Active
Organization
OLIVE FAMILY DENTAL LLC
Active
Other names
Olive Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMRA HUSSAIN DMD (DMD)
(602) 334-3950
Entity
Organization
Contact information
Practice address
120 W NORTH AVE, NORTHLAKE, IL 60164-2317
(708) 498-0050
(708) 498-0047
Mailing address
120 W NORTH AVE, NORTHLAKE, IL 60164-2317
(708) 498-0050
(708) 498-0047
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/23/2022
Last updated
12/23/2022
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