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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