Organization · Type 2 NPI
DR Sam DMD PC
Dental Clinic/Center · South Holland, IL
NPI number
1366975419
Active
Practice location
1022 E 162nd St
South Holland, IL 60473-2560
Mailing address
2120 W Washington Blvd, Suite. 306
Chicago, IL 60612-2346
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 019030498 (IL) |
Dental Clinic/Center: Definition to come...
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About NPI 1366975419
DR Sam DMD PC's National Provider Identifier is 1366975419, issued on Apr 6, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in South Holland, IL. The record was last updated on Apr 6, 2017.