Organization
SAMANTHA L HOLDER DENTAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA HOLDER D.D.S. (OWNER/GENERAL DENTIST)
(708) 478-2550
Entity
Organization
Contact information
Practice address
19848 S LA GRANGE RD, MOKENA, IL 60448-9339
(708) 478-2550
Mailing address
19848 S LA GRANGE RD, MOKENA, IL 60448-9339
(708) 478-2550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027057
IL
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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