| Olive Dental Pllc | |
|
9510 Beechnut St Suite A1 Houston TX 77036-6608 | |
| (713) 382-8654 | |
| Not Available |
| Full Name | Olive Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 9510 Beechnut St, Houston, Texas |
| Authorized Official Name and Position | Thaer Al Azzawi (GENERAL DENTIST/OWNER) |
| Authorized Official Contact | 7133828654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Dental Pllc 2119 Westheimer Rd Apt 1126 Houston TX 77098-1974 Ph: (713) 382-8654 | Olive Dental Pllc 9510 Beechnut St Suite A1 Houston TX 77036-6608 Ph: (713) 382-8654 |
| NPI Number | 1114384674 |
|---|---|
| Provider Enumeration Date | 01/28/2016 |
| Last Update Date | 01/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114384674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 31017 (Texas) | Primary |
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