Provider Demographics
NPI:1164892006
Name:HOLLAND DENTAL LLC
Entity Type:Organization
Organization Name:HOLLAND DENTAL LLC
Other - Org Name:UNIVERSAL DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VOICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-424-5901
Mailing Address - Street 1:9618 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2862
Mailing Address - Country:US
Mailing Address - Phone:708-394-5100
Mailing Address - Fax:708-907-3165
Practice Address - Street 1:300 E 162ND ST
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2141
Practice Address - Country:US
Practice Address - Phone:708-424-5901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027051261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental