Individual
SAMRA ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1630 45TH ST STE 104, MUNSTER, IN 46321-3959
(219) 924-8766
Mailing address
1250 S MICHIGAN AVE APT 1207, CHICAGO, IL 60605-3270
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12014199A
IN
1223G0001X
General Practice Dentistry
Primary
DN29365
FL
Other
Enumeration date
07/12/2023
Last updated
07/16/2024
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