Individual
ISRAA GOLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
9378 OLIVE BLVD, SUITE.1LL, OLIVETTE, MO 63132-3215
(314) 872-3930
Mailing address
145 LOG TRAIL DR, BALLWIN, MO 63011-3771
(773) 516-3739
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.029464
IL
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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