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Individual

SAMIR SABIR HASSAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
15800 S HARLEM AVE, ORLAND PARK, IL 60462-5212
(708) 658-3356
Mailing address
360 E SOUTH WATER ST APT 3505, CHICAGO, IL 60601-4146

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031668
IL
390200000X
Student in an Organized Health Care Education/Training Program
019.031668
IL

Other

Enumeration date
03/15/2018
Last updated
01/11/2022
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