| NPI | 1013200443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMAR BALOUL Pediatric Dentist 508-875-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 20603) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |